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Full text of "North Carolina Register v.14 no. 5 (9/1/1999)"

■■ f ■ / 



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NORTH CAROLINA 

REGISTEK 



RECEIVED 
SEP 1 1999 

'>■- - '-VERETT 



VOLUME 14 • ISSUE 5 • Pages 368 - 425 



September 1, 1999 



IN Tins ISSUE 

Agriculture - Veterinary Division 

ENR - Environmental Management 

Agriculture 

Cosmetic Art Examiners 

Cultural Resources 

Environment and Natural Resources 

Geologists, Board of 

Health and Human Services 

Justice 

Landscape Architects 

Nursing Home Administrators, Board of 

Rules Review Commission 

Contested Case Decisions 



PUBLISHED BY 

The Office of Administrative Hearings 
Rules Division 
PO Drawer 27447 
Raleigh, NC 27611-7447 
Telephone (919) 733-2678 
Fax (919) 733-3462 



This publication is printed on permanent, acid -free paper in compliance with G.S. 125-11.13 



For those persons that have questions or concerns regarding the Administrative Procedure Act or any of its 
components, consult with the agencies below. The bolded headings are typical issues which the given 
agency can address, but are not inclusive. 



Rule Notices. Filings. Register. Deadlines. Copies of Proposed Rules, etc. 

Office of Administrative Hearings 

Rules Division 

Capehart-Crocker House (919) 733-2678 

424 North Blount Street (9 1 9} 733-3462 FAX 

Raleigh, North Carolina 27601-2817 



contact: Molly Masich, Director APA Services 
Ruby Creech. Publications Coordinator 



miiiasich@oah. state. nc. us 
rcreech@oah.state.nc.us 



Fiscal Notes & Economic Analysis 

Office of State Budget and Manageaient 

116 West Jones Street 

Raleigh, North Carolina 27603-8005 

contact: Warren Plonk, Economist III 



(919) 733-7061 
(919) 733-0640 FAX 

wplonk@osbm.state.nc.us 



Rule Review and Legal Issues 

Rules Review Commission 
1307 Gienwood Ave., Suite 159 
Raleigh, North Carolina 27«)5 

contact: Joe DeLuca Jr., Staff Director Counsel 
Bobby Bryan, Staff Attorney 



(919) 733-2721 
(919) 733-9415 FAX 



Legislative Process Concerning Rule-making 

Joint Legislative Administrative Procedure Oversight Committee 

545 Legislative Office Building 

300 Nonh Salisbury Street (919) 733-2578 

Raleigh, North Carolina 276 11 (919) 715-5460 FAX 



contact: Mary Shuping, Staff Liaison 



marys@nis.ncga.slate.nc.us 



County and Municipality Government Questions or Notification 

NC Association of County Commissioners 

215 North Dawson Su-eet (919)715-2893 

Raleigh, North Carolina 27603 

contact: Jim Blackburn or Rebecca Troutman 



NC league of Municipalities 
215 North Dawson Street 
Raleigh, North Carolina 27603 

contact: Paula Thomas 



(919)715-4000 



This publication is printed on permanent, acid-free paper in compliance with G.S. 125-1 1.13 



NORTH CAROLINA 
REGISTER 




Volume 14, Issue 5 
Pages 368 - 425 



September 1, 1999 



This issue contains documents officially filed 
throuah Ausust 11. 1999. 



Office of Administrative Hearings 

Rules Division 

424 North Blount Street (27601 ) 

PO Drawer 27447 

Raleigh. NC 27611-7447 

(919)73.^-2678 

FAX (919)7.^.^3462 



IN THIS ISSUE 



I. IN ADDITION 
Agriculture 

Veterinary Division 368 

Environment and Natural Resources 

Environmental Management 369 

II. RULE-MAKING PROCEEDINGS 
Cultural Resources 

Archives and History 370 

Environment and Natural Resources 

Health Services 370-372 

Health and Human Services 

Medical Care Commission 370 

Licensing Boards 

Geologists. Board of 372-373 

Landscape Architects 373 

III. PROPOSED RULES 
Agriculture 

Pesticide Board 374 

Health and Human Services 

Facility Services 374-392 

Vocational Rehabilitation 392 - 393 

IV. TEMPORARY RULES 
Health and Human Services 

Medical Assistance 394-398 

Licensing Boards 

Nursing Home Administrators. Board of . . 398 - 401 

V. APPROVED RULES 402-415 

Environment and Natural Resources 

Coastal Management 

Marine Fisheries 

Wildlife Resources 
Justice 

Criminal Justice Education and Training Standards 

Sheriffs" Education and Training Standards Commission 
Licensing Boards 

Cosmetic Art E.xaminers 



Julian Mann III. Director 

Camille Winston. Deputy Director 

Molly Masich, Director of APA Services 

Ruhy Creech. Publications Coordinator 

Jean Shirley. Editorial Assistant 

Linda Dupree, Editorial Assistant 

Jessica Flowers. Editorial Assistant 



VL RULES REVIEW COMMISSION 416 420 

VII. CONTESTED CASE DECISIONS 

Index to ALJ Decisions 42 1 - 42.S 

VIII. CUMULATIVE INDEX 1 67 



Narrli Carnlmu Rt'iiisier is published scmi-nionlhly for SI 93 per year hy the Office olAdminishalive Hearings, 424 Nonh Blount Street. Raleigh. NC 
27601 ( ISSN 1 52(10604) to mail at PenodicaK Rales is paid at Raleigh. \C \H )ST\1 ASTF.R Send Address changes lo the Nurth Carolina Ri\iiisrer. 
PO Drawer 27447. RaleiL'h. NC 2761 1-7447 



NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM 



The North Carolina Admuiistrative Code (NCAC) has four major subdivisions of rules. Two of these, titles luul chapters, 
are maiuiaton: The major subdivision of the NCAC is the title. Each major department in the North Carolina executive 
branch of government has been assigned a title number. Titles are further broken down into chapters whu h shall be 
numerical in order. The other two. subchapters and sections are optioned subdivisions to be used by agencies when 
appropriate. 



TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE 
TITLE DEPARTMENT LICENSING BOARDS CHAPTER 



1 


Administration 


Acupuncture 


1 


1 


Agriculture 


Architecture 


-> 


3 


Auditor 


Athletic Trainer Examiners 


3 


4 


Commerce 


Auctioneers 


4 


5 


Correction 


Barber Examiners 


6 


6 


Council of State 


Certified Public Accountant Examiners 


8 


7 


Cultural Resources 


Chiropractic Examiners 


10 


8 


Elections 


Employee Assistance Professionals 


11 


9 


Governor 


General Contractors 


12 


10 


Health and Human Services 


Cosmetic Art Examiners 


14 


11 


Insurance 


Dental Examiners 


16 


12 


Justice 


Dietetics/Nutrition 


17 


13 


Labor 


Electrical Contractors 


18 


14A 


Crime Control & Public Safety 


Electrolysis 


19 


15A 


En\ironment and Natural Resources 


Foresters 


:() 


16 


Public Education 


Geologists 


21 


17 


Revenue 


Hearing Aid Dealers and Fitters 


1 *l 


18 


Secretary of State 


Landscape Architects 


26 


19A 


Transportation 


Landscape Contractors 


28 


20 


Treasurer 


Marital and Family Therapy 


31 


*21 


Occupational Licensing Boards 


Medical Examiners 


32 


T-l 


Administrative Procedures (Repealed) 


Midwifery Joint Committee 


33 


23 


Community Colleges 


Mortuary Science 


34 


24 


Independent Agencies 


Nursing 


36 


25 


State Personnel 


Nursing Home Administrators 


37 


26 


Administrative Hearings 


Occupational Therapists 


38 


27 


NC State Bar 


Opticians 


40 






Optometry 


42 






Osteopathic Examination & keg. (Repealed) 


44 






Pastoral Counselors. Fee-Based Practicing 


45 






Pharmacy 


46 






Physical Therapy Examiners 


48 






Plumbing, Heating & Fire Sprinkler Contractors 


50 






Podiatry Examiners 


52 






Professional Counselors 


53 






Psychology Board 


54 






Professional Engineers & Land Surveyors 


56 






Real Estate Appraisal Board 


57 






Real Estate Commission 


58 






Refrigeration Examiners 


60 






Sanitarian Examiners 


62 






Social Work Certification 


63 






Soil Scientists 


69 






Speech & Language Pathologists & Audiologists 


64 






Substance Abuse Professionals 


68 






Therapeutic Recreation Certification 


65 






Veterinary Medical Board 


66 



Note: Title 2 1 contains the chapters of the various occupational licensing boards. 



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IN ADDITION 



This Secrion contains public notices that are required to he published in the Register or have been approved b\ the Codifier of 
Rules for publication. 



NOTICE OF PUBLIC HEARING ON PROPOSED TEMPORARY RULES 

Notice is hereby given that the North Carolina Board of Agriculture will conduct a public hearing on September 2 1 , 1999, 
t 1 ():00 a.m. at the Gov. James B. Hunt, Jr. Horse Complex at the State Fairgrounds, corner of Trinity Road and Youth Center Road, 
laleigh, NC, on proposed temporary rules for mandatory testing of equines for equine infectious anemia (EIA). 

Background. Pursuant to Section 13.6 of Session Law 1999-237, the Board of Agriculture is required, no later than 
)ctober I, 1 999, to adopt rules to provide for the mandatory testing of horses and other equine for EIA prior to sale or assembly at 
ublic places. Folkming adoption of temporary rules, the Board will begin rule-making proceedings to adopt permanent rules. 

Summai^. The proposed rules: 

( 1 ) would require all equine more than six months of age to be accompanied by proof of a negative EIA test when sold 
or brought to any public place. (Existing rules require the testing of horses imported into the state); 

(2) would permit the testing of equine at a market or sale and require the equine to be held pending test resi ' s; 

(3) would require equine testing pt)sitive for EIA to be either euthanized, branded and isolated or sold for slaughter; 

(4) would require quarantine and testing of equine that have been exposed to positive reactors; and 

(^) would require markets or sale operators to obtain prior approval before conducting equine sales. 

Copies of the proposed rules may be obtained by calling the Veterinary Division of the Department of Agriculture and 
'onsumer Services at (919) 733-7601. 

Comment Procedures. Anyone may offer comments on the proposed temporary rules by appearing at the public hearing or 
y submitting written comments no later than September 17, 1999, to David S. McLeod. Secretary, North Carolina Board of 
.griculture, PO Box 27647, Raleigh, NC 2761 1 . 



f:5 NORTH CAROLINA REGISTER September I, 1999 368 



IN ADDITION 



TITLE ISA - DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES 

CHAPTER 2 - ENVIRONMENTAL MANAGEMENT | 

This is a notice of intent to adopt temporary rules for protection of riparian buffers in the Tar-Pamlito River Basin The 

Department of En vironment and Natural Resources plans to request that the NC Environmental Management Commission adopt such 
temporar\' rules to provide interim protection for riparian areas while permanent rules calling for the same protections are undergoing 
a full rule-making process through the EMC. Permanent rules to protect riparian buffers and control nonpoint sources of nutrients 
are scheduled for adoption by the EMC in December 1999. and would become effective August 1, 2000. A Notice of Text was 
published for these permanent rules in the August 2. 1999 edition of the NC Register. 14:.^. pages 162-185. 

Protection of riparian buffers would help minimize nonpoint source nutrient inputs to streams in the Tar-Pamlico River Basin. The 
temporary' and permanent rules are proposed as part of the Basins Nutrient Sensitive Waters Strategy, a priority issue in the slates 
Tar-Pamlico River Basinwide Water Quality Plan. Chapter .329, Session Laws 1 999 ( House Bill 1 1 60) gi\ es the EMC authority to 
adopt temporary rules in the Tar-Pamlico, Cape Fear, and Catawba River Basins to protect water quality standards as required to 
implement Basinwide Water Quality Plans for these Basins. 

The purpose of this announcement is to encourage those interested in this rulemaking to provide oral or written comments on 
proposed temporary rules for riparian buffer protection. A copy of the rules was published in the August 2, 1999 NC Register, or 
can be obtained by contacting Marsha Byrd. Division of Water Quality, (919) 7.3.3-508,'^ ext. 558. Public hearings are being held on 
these and other proposed nonpoint source nutrient rules for the Basin on September 2""*, 1999 (see below). We encourage you lo 
provide oral or written comments at the hearing if interested, or written comments separately. 

Please submit comments to Rich Gannon. DENR. Division of Water Quality. Planning Branch. 1617 Mail Service Center. Raleigh. 
NC 27699-1617. Questions may be directed to Rich Gannon at (919) 733-508.3 ext. 356, or rich_gannon(?h2o.enr. state. nc. us. 

Public Hearing for Proposed Nonpoint Source Nutrient Rules for Tar-Pamlico River Basin 

Thursday. September 2. 7:00 pm i 

Nashville. NC 

Nash County Agriculture Center Auditorium 

Ag Center Drive 

On the north side of U.S. 64 Business (Eastern Ave.) 

Nash County Extension office: (252)459-9810 



369 NORTH CAROLINA REGISTER September /, 1999 14:5 



RULE-MAKING PROCEEDINGS 



i 



A Notice of Rule-making Proceedings is a statement of subject matter of the agency 's proposed rule making. The agency must 
publish a notice of the subject matter for public comment at least 60 days prior to publishing the proposed text of a rule. 
Publication of a temporary rule sen.es as a Notice of Rule-making Proceedings and can be found in the Register under the 
section heading ofTemporan Rules. A Rule-making Agenda published by an agency senses as Rule-making Proceedings and 
can be found in the Register under the section heading of Rule-making .Agendas. Statutory- reference: G.S. I50B-2I .2. 



TITLE 7 - DEPARTMENT OF CULTURAL 
RESOURCES 

CHAPTER 4 - ARCHIVES AND HISTORY 

Tk TOtice of Rule-making Proceedings is hereby given by the 
1 V Ncn-th Carolina Department of Cultured Resources in 
accordance with G.S. 1508-21.2. The agency shall subsequently 
publish in the Rei;istcr the text of the rules it proposes to adopt 
as a result of this notice of rule-making proceedings and any 
comments received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 7 

\ICAC 4S .1)101-. (JJ()9. Other rules may be proposed in the 
course of the rule-making process. 

Authority for the rule-making: G.S. I21-4(8).(9): I43B-!0(j): 
l43B-62{2jd: I43B-71 

Statement of the Subject Matter: These Rules address the 
purposes, operation, aiul services available from the Try on 
malace Historic Sites and Gardens in New Bern. North 
Carolina, and have not been update i since 1 989. In particular, 
the fee schedule needs adjustment to place it in line with current 
levels. 

Reason for Proposed Action: These proposed amendments 
are needed to accurately reflect the current administrative status 
of the Tryon Palace Historic Sites and Gardens and to meet 
state requirements for eanied admission receipts for FY 1999- 
2000. Nearly all admission receipts are utilized to fund 
temporaiy minimum wage employees as guides, character 
interpreters, or crafts demonstrators. Since the la.'it ticket price 
increase over 10 years ago. there have been substantial 
increases in the mininuun wage. The currem level of visitation 
appears to be sufficiently high lo support this change and is in 
line with recent increir'ies at Old Salem and other similar sites. 

Comment Procedures: Written comments may be submitted 
to Boyd D. Catliey. Division of Archives atid History. NC 
Department of Cultural Resources. 4614 Mad Service Center. 
109 East Jones Street. Raleigh. NC 27699-4614. 



i 



TITLE 10 - DEPARTMENT OF HEALTH AND 
HUMAN SERVICES 



CHAPTER 42 - INDIVIDUAL AND FAMILY SUPPORT 



-\wtice of Rule-making Proceedings is hereby given by the 
ly Medical Care Commission in accordance with G.S. 
I50B-2I.2. The agency shall subsecjuently publish in the 
Register the text of the rule(s) it proposes to adopt as a result of 
this notice of rule-making proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: W 

NCAC 42B .1201. .1212-. 1215. .1707. .I,S0.\ .201 .^-.2014. 
.250I-.25O3: 42C .2005. .2012-.2014. .2207. .2214. .2501- 
.2506. .2703. .3401-. 3402. .3701. .3703. .3801-.381O. .3901- 
.3903: 42D .1301 -.1303. .1401-. I4U2. .1407. .141 2-. 1416. 
.1503. .1605. .1804. .1813. .1832-. 1833. .1901-. 1910. .2001- 
.201 1. .2102. Other rules may he proposed in the course of the 
rule-making process. 

Authority for the rule-making: G.S. 131D-2: I3ID-4.3: 
131D-4.5: 13ID-4.6: 131D-8; 143B-165 

Statement of the Subject Matter: Medication Administration 
and Storage: Behavioral Intervention Training: Staff 
Qualifications and Responsibilities for Medication Aides. Aide 
Supenisors. Management Staff: Staffing Levels: Management 
of Adult Care Homes: First Aid Training: Due Process and 
Appeal Rights for Resident Discharge or Transfer: Issuing and 
Renewing Licenses Based on Compliance Histoiy: Special Care 
Units for Residents with Alzheimer's Disease and Related 
Disorders and for Persons with Mental Health Disidnlities: 
Resident Assessment Timeframe ami Training: and Ma.ximum 
Water Temperature Levels. 

Reason for Proposed Action: Legislation (Senate Bill 10) 
resuhing from tlw Department of Health and Human Services' 
Long Term Care Safety Initiative resulted in requirements for 
new, higher standards of care for adult care homes. These new 
standards are to he estcdilished in penneinent rules to be adopted 
by the Medicid Cine Commission to address areas such as 
medication administration, behaviond intenention training, 
supeirision of aides, discharge/transfer due process and appeal 
rights, issuing and renewing licenses based on compliance 
histoiy, and special care units and their disclosure. 

Comment Procedures: Written comments may he submitted 
to Doug Barrick. Division of Facility Senices, Group Care 
Licensure Section. 2708 Mad Sen-ice Center. Raleigh, NC 
27699-2708. 



TITLE 15A - DEPARTMENT OF ENVIRONMENT 



14:5 



NORTH CAROLINA REGISTER 



September 1, 1999 



370 



RULE-MAKING PROCEEDINGS 



AND NATURAL RESOURCES 

CHAPTER 13 - SOLID WASTE MANAGEMENT 

•K jntice of Rule-making Proceedings is hereby given by the 
1 V ENR Commission for Health Senices in accordance witli 
G.S. 1 508-21.2. The agency shall subsequently publish in the 
Register the text of the riile(s) it proposes to adopt as a result of 
this notice of rule-nuikini; proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 

J5A NCAC 13A.0H)I-.0I04. .0106. .0108. .0110. .0112-.01I3. 
.01 18. Other rules may be proposed in the course of the rule- 
making process. 

Authority for the rule-making: G.S. 130A-294{c), 150B-21.6 

Statement of the Subject Matter: 

15A NCAC ISA .0101 - GENERAL - Establishes the State 

agency which will administer the hazardous waste management 

program, makes State substitutions for federal agencies and 

incorporates into the rules certain publications. 

ISA NCAC 13A .0102 - DEFINITIONS - Defines the meanmg 

of key words as used in the rules. 

ISA NCAC 13A .0103 - PETITIONS - PART 260 - Establishes 

procedures to petition for rule changes. Establishes freedom of 

information and confidential information. 

ISA NCAC 13 A .0104- PUBLIC INFORMATION -PART 2 - 

Establishes freedom of information and confidential information 

requests procedures. 

ISA NCAC 13A .0106 - IDENTIFICATION AND LISTING OF 

HAZARDOUS WASTES -PART 261 -Identifies cluiracteristics 

of hazardous waste and lists certain hazardous wastes. 

ISA NCAC 13A .0108 - STDS APPLICABLE TO 

TRANSPORTERS OF HAZARDOUS WASTE - PART 263 - 

Establishes standards- which apply to transporters of hazardous 

waste. 

ISA NCAC 13A .0110 - INTERIM STATUS STDS FOR 

OWNERS-OP OF HWTSD FACILITIES - PART 265 - 

Establishes interim status standards for owners and operators 

of hazardous waste treatment, storage and disposal facilities. 

ISA NCAC 13A .0112 - LAND DISPOSAL RESTRICTIONS - 

PART 268 - Establishes land disposal restrictions. 

ISA NCAC 13A .0113 - THE HAZARDOUS WASTE PERMIT 

PROGRAM - PART 270 - Establishes pentiit application 

information requirements and permit procedures. 

ISA NCAC 13A .0118 - STANDARDS FOR THE 

MANAGEMENT OF USED OIL -Establislies standards for the 

management of used oil. These standards cover used oil 

generators, transporters, processors and refiners, burners and 

marketers. 

Reason for Proposed Action: 

ISA NCAC 13A .0101 - To properly identify the Department: to 

properly ideniifi. definitions that are exempt in certain rules: 



and to eliminate the Annual Report rec/uircinents as required by 
Section 27.10 of House Bill 53 of the Sci and E.xtra Session (f 
the 1996 North Carolina Legislature. ▲ 

ISA NCAC 13A .0102 - All revisions art (f technical nature. " 
ISA NCAC 13A .0103 - Has been revised to accurately reflect 
to procedure that must be followed to Petition for Modification 
or Revocation of rules. 

ISA NCAC 13A .0104 - Changes m .i)l04(aHll are to 
accurately reflect those Federal Regulations that are included 
in Subpart A. .OI04(all2) has been revised to correct the 
address of the Division of Waste Management: .0104la)(2) has 
been deleted. The definitions that were in this Subparagraph 
are included elsewhere in this Section or are no longer required. 
.0104(b) has been revised to properly exclude those Federal 
Regulations that North Carolina is not adopting. 
ISA NCAC 13A .0106 - This Paragraph has been expanded to 
include new EPA requirements. These rei/iiirements provide an 
exemption from hazardous waste regulations for certain 
comparable/syngas fuels. 

ISA NCAC13A .0108 - The revisions to this rule do t^vo things: 
Sets a time frame in which a non-resolved manifest discrepancy 
must be reported to the Department: and i icaiiy defines what is 
considered a manifest discrepancy. 

ISA NCAC 13A .0110 - Adds 40 CER 265.121 'Tost-closure 
requirements for facilities that obtain enforceable documents in 
lieu of post-closure pertnits" to Subpart G, "Closure and Post- 
Closure. " 

ISA NCAC13A .0112 - The proposed amendment will add 4(^ 
CER 268.49 to (Subpart D). "Treatment Standards", tM 
provide alternative land disposal treatment standards for 
contaminated soil. 

ISA NCAC 13A .0113 - These are technical corrections. 
ISA NCAC 13A .0118 - These are technical corrections. 

Comment Procedures: Comments may be submitted to 
Harold McCarthy, NC Hazardous Waste Section. 401 Oberlin 
Road, Suite 150, Raleigh, NC 27605- J350, telephone number 
733-2178, ext.247. 



CHAPTER 18 - ENVIRONMENTAL HEALTH 

A TOtice of Rule-making Proceedings is hereby given by the 
I y DENR/Comniissionf>r Health Services in accordance with 
G.S. 1 50B-21.2. The agency shall subsequently publish in the 
Reijister the text of the rules it proposes to adopt as a result tf 
this notice of rule-making proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 

I5A NCAC 18C .1538. Other rules nun he proposed in ihe 
course of the rule-making process. M 

Authority for the rule-making: G.S. I30A-3I5 



371 



NORTH CAROLINA REGISTER 



September 7. 1999 



14:5 



RULE-MAKING PROCEEDINGS 



f 



Statement of the Subject Matter: National Priinan- Drinking 
Water Regulations: Consumer Confidence Reports. The 
Consumer Confidence Reports Rule requires community water 
systems to prepare and distribute water quality reports to their 
customers. 






CHAPTER 18 - ENVIRONMENTAL HEALTH 



♦ 



I 



Reason for Proposed Action: In order to meet the conditions 
of the primacy agreement with the US Environmental Protection 
Agency. North Carolina must adopt rules that are no less 
stringent than the Federal Regulations as required in Section 
1414(c)(4) of the Safe Drinking Water Act. The National 
Primary Drinking Water Regulations: Consumer Confidence 
Reports Rule was promulgated on August 19, 1998. 

Comment Procedures: Send comments to Martha Moore. 
Public Water Supply Section. 1634 Mail Senice Center, 
Raleigh, NC 27699-1634 or phone (919) 715-3243. 

CHAPTER 18 - ENVIRONMENTAL HEA' iH 

•\ -jotice of Rule-making Proceedings is hereby given by the 
1 y DENR/Coinmission for Health Services in accordance with 
G.S. 150B-21.2. The agency shall subsequently publish in the 
Resister the te.xt of the rules it proposes to adopt as a result of 
this notice of rule-making proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 

15A NCAC 18C .2007. Other rules may be proposed in the 
course of the rule-making process. 

Authority for the rule-making: G.S. 130A-3I5 

Statement of the Subject Matter: National Primaty Drinking 
Water Regulations: Interim Enhanced Surface Water Treatment. 
Waterbonie disease has been associated with a high level of 
particles passing through a water treatment plant, and this Rule 
strengthens the effectiveness and reliabilit}' of physical removed 
for particulate matter and microorganisms in general. This 
Rule optimizes treatment reliability and enhances physical 
removal efficiencies. 

Reason for Proposed Action: //; order to meet the conditions 
of the primacy agreement with the US Enviromnental Protection 
Agency, North Carolina must adopt rules that are no less 
stringent than the Federal Regulations as required in Section 
1413 of the Safe Drinking Water Act. The National Primary 
Drinking Water Regulations: Interim Enhanced Surface Water 
Treatment Final Rule was promulgated on December 16, 1998 
as required under 1412(b)(2)(c). 

Comment Procedures: Send comments to Tim Booinhower. 
Public Water Supply Section, 1634 Mail Service Center, 
Raleigh, NC 27699-1634 or phone (919) 715-3221. 



Tk -jotice of Rule-making Proceedings is hereby given by the 
1 V DENR/Commission for Health Serxices in accordance with 
G.S. 150B-21.2. The agency shall subsequently publish in the 
Register the te.xt of the rules it proposes to adopt as a result of 
this notice of rule-making proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 

15A NCAC 18C .2008. Other rules may be proposed m the 
course of the rule-making process. 

Authority for the rule-making: G.S. 130A-315 

Statement of the Subject Matter: National Primaty Drinking 
Water Regulations: Disinfectants and Disinfection Byproducts. 
This Rule provides protection from microbial pathogens while 
simultaneously ensuring decreasing health risks from 
disinfection byproducts. Several disinfection byproducts have 
been shown to cause cancer in laboratoiy animals. Levels of 
disinfection and disinfection byproducts in drinking water will 
be reduced. 

Reason for Proposed Action: //; order to meet the conditions 
ofthepritnacy agreement with the US Envirotmiental Protection 
Agency, North Carolina must adopt rules that are no less 
stringent than the Federal Regulations as required in Section 
1413 of the Safe Drinking Water Act. The National Primary 
Drinking Water Regulations: Disinfectants and Disinfection 
Final Rule was promulgated on December 16, 1998 as required 
under 1412(b)(2)(c). 

Comment Procedures: Send comments to Hornlecm Chen. 
Public Water Supply Section, 1634 Mail Seirice Center, 
Raleigh. NC 27699-1634 or phone (919) 715-3221. 



TITLE 21 - OCCUPATIONAL LICENSING BOARDS 

CHAPTER 21 - BOARD OF GEOLOGISTS 

-\ jotice of Rule-making Proceedings is hereby given by the 
1 V NC Board for Licensing of Geologists in accordance with 
G.S. 150B-21.2. The agency shall subsequently publish in the 
Register the te.xt of the rule(s) it proposes to adopt as a result of 
this notice of rule-making proceedings and any comments 
received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 21 

NCAC 2 1 .0501, 0514-.0515, . 1 101 -.1102. Other rules may he 
proposed in the course of the rule-making process. 



14:5 



NORTH CAROLINA REGISTER 



September 1, 1999 



372 



RULE-MAKING PROCEEDINGS 



Authority for the rule-making: G.S. 89E 

Statement of the Subject Matter: To include Code of 
Professional Conduct as rules: to amend present rides to 
conform to changes to the Geologist Act as amended by the 1 999 
General Assembly. 

Reason for Proposed Action: The Code of Professional 
Conduct was adopted following initial organization of the 
Board, this change includes them as part of the Board rules. 
The changes made by the 1999 General Assembly affected 
disciplinary- changes and additions in the Geologx Licensing 
Act. 

Comment Procedures: Comments may be directed to Robert 
Upton at PO Box 41225. Raleigh. NC 27629. 

CHAPTER 26 - LICENSING BOARD OF LANDSCAPE 
ARCHITECTS 



m 



'tice of Rule-making Proceedings is hereby given by the 
NC Board of Landscape Architecture in accordance with 



G.S. I50B-2L2. The agency shall subsequently publish in the 
Register the text of the rule(s) it proposes to adopt as a result of 
this notice of rule-making proceedings and any comment^ 
received on this notice. ™ 

Citation to Existing Rules Affected by this Rule-Making: 21 

NCAC 26 .OlOL .0104-.0W5. Other rules nun be proposed in 
the course of the rule-making process. 

Authority for the rule-making: G.S. 89.\ 

Statement of the Subject Matter: Mailing address of Board. 
Teniporaiy Licenses, and Fees for examination and late 
penalties. 

Reason for Proposed Action: The 1999 Session of the 
General Assembly deleted the provision of the act that provides 
for temporary licenses. Also the General AssendTly changed 
how examination fees may be charged. The mail address of the 
Board has changed also. 

Comment Procedures: Conunents may be directed to Robert 
Upton at PO Box 41225. Raleigh, NC 27629. 



373 



NORTH CAROLINA REGISTER 



September I, 1999 



14:5 



PROPOSED RULES 



This Section contains the text of proposed rules. At least 60 days prior to the publication of text, the agency published a Notice 
of Rule-making Proceedings. The agency must accept comments on the proposed rule for at least 30 days from the publication 
date, or until the public hearing, or a later date if specified in the notice by the agency. The required comment period is 60 daxs 
for a rule that has a substantial economic impact of at least five million dollars ($5,000,000). Statutoiy reference: G.S. 150B- 
21.2. 



TITLE 2 - DEPARTMENT OF AGRICULTURE 

Notice is hereby given in accordance with G.S. 150B-2I .2 
that the North Carolina Pesticide Board intends to amend 
the rules cited as 2 NCAC 9L .0502. .1201. Notice of Rule- 
making Proceedings was published in the Register on July J, 
1999. 

Proposed Effective Date: July 1. 2000 



(3) 



Carolina Pesticide Board; except for federally 
registered ant control products containing arsenic 
trioxide (solid formulation tnanufactured m a sealed 
metal container only ) for: 

(a) domestic outaoor - domestic dwellings, or 

(b) domestic indoor - domestic dwellings; 
any pesticide approved under 2 NCAC 9L .0318. 



Authority G.S. 143-44(Ha).(b): 143-441: 143-458. 



Instructions on How to Demand a Public Hearing (must be 
requested in writing within 15 days of notice): Any person may 
request a public hearing on the proposed rules by submitting a 
request in writing no later than September 16. 1999. to James 
W. Burnette. Jr.. Secretary. NC Pesticide Board, c/o Food and 
Drug Protection Division. Pesticide Section. NC Department of 
.Agriculture and Consumer Services. PO Box 27647. Raleigh. 
NC 27611. 

Reason for Proposed Action: This rule-making proceeding 
was initiated as a result of a petition submitted by Dr. John A 
mTodhunter. SRS International Corporation, on behalf of Grant 
Laboratories. Inc. 



SECTION .1200 - ARSENIC TRIOXIDE 

.1201 RESTRICTIONS ON USE AND STORAGE 

All pesticide formulations containing the active ' igredient 
arsenic trioxide shall not be used or stored insiue or in the 
immediate vicinity of any building used as a human dwelling. 
dwelling; except for federally registered ant ccintrol products 
containing arsenic trioxide (solid formulation manufactured in 
a sealed metal container only) for: 

( 1 ) domestic outdoor - domestic dwellings, or 

(2) domestic indoor - domestic dwellings. 

Authority G.S. l43-44()lb): 143-441. 



» 



Comment Procedures: Written comments may be submitted 
no later than October 1. 1999 to James W. Burnette. Jr.. 
Secretary-. NC Pesticide Board, c/o Food and Drug Protection 
Division. Pesticide Section. NC Department of Agriculture and 
Consumer Sen-ices. PO Box 27647. Raleigh. NC 27611. 

Fiscal Impact 
State Local Sub. None 
/ 

CHAPTER 9 - FOOD AND DRUG PROTECTION 
DIVISION 

SUBCHAPTER 9L - PESTICIDE SECTION 

SECTION .0500 - PESTICIDE LICENSES 

.0502 LIST OF RESTRICTED USE PESTICIDES 

For the purpose of this Regulation a restricted use pesticide is: 

( 1 ) any pesticide required by the environmental 
protection agency to bear the designation on its 
labeling "Restricted Use Pesticide"; 

(2) arsenic trioxide. all formulations of which must be 
sold and/or purchased in accordance with additional 
regulations (2 NCAC 9L .1200) adopted by the North 



TITLE 10 - DEPARTMENT OF HEALTH AND 
HUMAN SERVICES 

Notice is hereby given in accordance with G.S. I50B-21.2 
that the Division of Facilit}- Sen-ices intends to adopt the 
rules cited as 10 NCAC 3S .1101. .1201-. 1207. .1301-. 1303. 
.1401. .15111. .1601. .1701-. 1702. .1801-. 1806. .1901-. 1903. 
.2001-.2UU2. .2101-.2IU6: and repeal the rules cited as 10 
NCAC3S.O1O8-.O109. .0207-.021I. .02I3-.0214. .0307-.0308. 
.0407-.()40H. .0506:0511. .0614-.06I9. .0706-. 0707. .0806- 
.0808 .09U1-.0904. .1001 -.1006. Notice of Rule-making 
Proceedings was published in the Register on June 15. 1998. 

Proposed Effective Date: July 1. 2000 

A Public Hearing will be conducted at 2:00 p.m. on October4. 
1999 at the Council Building. Room 20L 701 Barbour Drive. 
Raleigh. NC. 

Reason for Proposed Action: To repeal obsolete rules and 
adopt ne^v ones that reflect current standards of practice in the 
area of cardiac rehabilitation. 

Comment Procedures: Anyone wishing to comment on these 



14:5 



NORTH CAROLINA REGISTER 



September I, 1999 



374 



B^ 



PROPOSED RULES 



proposed rides should contact Jackie Sheppard, APA 
Coordinator. Division of Facility Sen'ices. 701 Barbour Drive. 
Raleigh, NC 27603, (919) 733-2342. Written comments must be 
received no later than the date and time of the hearing. 

Fiscal Impact 
State Local Sub. None 
/ 

CHAPTER 3 - FACILITY SERVICES 

SUBCHAPTER 3S - CERTIFICATION OF CARDIAC 
REHABILITATION PROGRAMS 

SECTION .0100 - GENERAL INFORMATION: 
ADMINISTRATION 

.0108 DEFINITIONS 

The — following — definitions — witl — apply — t hroughout t l iis 
Subciiapter: 

til " Cardiac Rei i abiiitation Program" means a program 
ce r ti f i e d u n der Article 8 ofCiiapte r 1 3 1 C ot the Nortl i 
Caro l ina Ge ne r al Sta t utes fo r the delivery of caidiac 
r e h a bi litatio n services to clients, in enviro n n i enl s 
o the r than hospitals and inc l udes, but shall not be 
limited — to: — coordi n ated. — p h ysician-dire c ted. 
in d i v i dualized p r ograms of therapeutic act i vity and 
lif e st y le modifications which are designed to assist 
the — cardiac — patie n t — rn — attaining — the — highest 
r e h a bil itat i ve potential; 

(2) "Ce r i i Ucalion" means the issuanc e of a certificate by 
the Depaitme n t upon determinatio n that caid i ac 
r e h abil i ta ti o n se r vices offered at a g i ven p r og r am site 
are in su b s t antial comp l iance w i th — a ll Ca rdi ac 
Rehabili t a ti on P r ogra m — r ules contained — in this 
Subc h apter and the prov i sio n s of G.S. Chapter I .^ I E. 
A r ticle 8; 

tfH "Departmen t " means the Department of Human 
Resources: 

t=H "P r og ra m Director" means the p e r so n who supervises 
the s t aff of a c er tified Cardiac Rehab i litation P r ogiam 
and directs a l l facets of tl ' ie program: 

t5l "S i te" means t h e facility in which the Ca r diac 
Reha bil itation Prog r am is held. 

t(r) "Cardiac therapy sess i o n " means that period of time 
that is staff diiecled and consists of sp ecific warm-up. 
stimulus p h ase, and cool-down acliviiies; 

t^ Regula r fc j |low-up intervals - three, six. 12 months; 

t8l "Div i sion" means the Division of Facility Services. 

Authorit\ G.S. I3IE-169. 

.0109 POLICIES AND PROCEDURES 

The P r og r am Di r ect or of each Card i ac Rehabilitation Program 
shall assure w ri t t en policies a n d i 



shall cover at least the following areas: 
t+1 admission of patie n ts. 
t2) p atien t assessment; prescripti on ti nd t h era py; 
t5l patien t follow-up; 
t+1 patient discharge; 

tfh maintenance and rete n tion of ine di cal re cor dr. 
ttr) orientatio n of all progra iii pe i soi iii el. 
t?1 personnel records whicl i -trtdtidir^ 

credentials; 
tSl communication with patient's Tcferr al a n d perscmttt 

physicia n s, if any. 
t9l procedures — for reco r ding and — r eviewing — of all 

incidents and accidents: 
t+&1 confidentiality of medical reco rd information; 
ti-fi emergency p rocedures. 

Authorities. 1 31 E- 1 69. 

SECTION .0200 - CERTIFICATION 

.0207 CERTIFICATION REQUIRED 

tal For a caidiac rehab i l i tation progrann n+icTertif 
G.S. Chapter 13 IE. A r tic le 8. a cardiac l e hab 
must be issued a certificate by the Deparimeni when the 
Division deterr n i n es that the prog r a n r <;ub sta nli all y'f omplies 
w i th t h e provisions of G.S. C ha pte r i31F. ."ATtrde-HrantfT^TH 
substantial complia n ce — w i th t h e ru le s - cormnncd i n th i s 



liable 



I policies and procedures w n icn are avail, 
a n d implemented by the s t a f f. Tliese policies and procedures 



Su b chapter. ^ 

tbi A certificate issued to a -speci fi c ca r d i ac - r eh ahilitatio ™ 

program by the Department is not transferrable or assignable. 

exce p t with prior w i-i tte ii appro\ ' al of the Department. — A 

cui 'r ei i tly valid cert i fica t e m ust also be p osted i n a conspicuous 

place on the certified premises. 
tci A n ew ce r tification shall be r equired when there is a 

cha n ge of ei t her the p r ogram di r ecto r o r medic aftlTrec to r . T he 

necessity and type of review shall be at tl i e disc re t i on of il ic 

D i visio n . 

Authority G.S. 131E-169. 

.0208 TYPES OF CERTIFICATION 

Two types of ceilifica t ion are issued to Cardiac RehatTtfrtatinn 
P r og r ams. They are as fol l ows : 
t+1 Provisional Cer ti f i c ati o n. 

ta) If a new program is star tin g, th e Program 
D i rector w i l l p r epa r e and submi t- a de t ailed 
applicatio n clea r l y describin g -the program's 
scope of se r vices and the s ta f f a n d th ei r 
q ual i fica t ions, and de li neate fa cili lies and t he 
equip m ent to be u til i/ : ed. — There m ust be 
sialf has attended, pnortoi he 
r^irtTgrarn. a trrttrring 
w o r ksh(ip o n c a r dia c r ehabrti tation. -5c+ic 
[ftrt and giA- e n bv ^Ttm.— crp 



cur r ently certified progra rns^ ct a ctimbmatrrm 
of s taff from several certified program??. 



375 



NORTH CAROLINA REGISTER 



September 7, 1999 



14:5 



PROPOSED RULES 



% 



♦ 



(tr) Provisional certi t ication must occurp ri o r to the 

starting — date — of — tirc — prog r a m . ff — the 

Depa r tment, up i ui review of an application and 

supporting docu m entation, dete i iriir i es liiat a 

caidiac re h a h iliiatio n program co m plies wi t h 

G.S. Chapte r 13IE, Ar ti cle 8 and the r ules 

contained in th i s Su b chap t e r , th en a p r ovis io nal 

ceniFicate shall be issued by t he Departmen t 

w i thout an on-s it e r ev i ew being m ade. 

tc^ A provisional ce r t if icate is also issued when a 

program is r eviewed for recertifica t ion and 

does not co m ply with the rules con t a i ned in 

this Subchapter, w h e n failure to comply does 

not endanger the health, safe t y, or welfare of 

patients — being — served — by — the — program. 

Provisi onal c ertitication will not exceed six 

mont hs. 

i&i A p r ov i s i ona l certification may be extended fo r 

u p to three months when a new prog r a m b eg in s 

and vyhen extreme circumstances o c cu r to 

restrict the development of the p r og r a m . T h e 

program must apply in writing t o the Division 

for an extension. 

ttt Full certification is granted when a program i s found 

to he substantially in fu l l compliance w i th t h e r ules 

contained in this Subchapter and G.S. Chap t er I .^ IE, 

A rt icle 8. A lette r re quest i ng a full certitication w i l l 

h e submitted during the tlrst three months o t the 

pr og r am's operation . 



Aia/ionry G.S. 131E-169. 

.0209 APPLICATION 

fai A n ap pli cat i on fo r ce r titicat i o n shall b e sub m itted to t he 
De p a ii men i prio r to a certificate being issued. 

t+r) A n appl i catio n shal l h e su bmitt ed p r io r to th e occurrence 
of a n y of the fo ll ow in g c ir cums t a n ces : 

tfi P r ov i s i onal certifica ti on of a new prog r am : 

^21 Cha n ge o f prem i ses ( i nitial certification of new 

p r emises or addi t ion of new site); 
trH Cha n ge of ownership ( i nitial certificat i on of new 

ow n e r ), program director or medical director: and 
t^ Recertification. 

Authority G.S. I3IE-169. 



P r og r am D irec to r . 
tci The Program Director shall p r ovide and make available to 



represen t at i ves of the Division 



ds dee m ed neces&aiy to 



ivision records 
d e m o n strate co mp liance with this Su b chapter. 

ttf) Routi n e inspectio n s shall b e conducted by one o r m o r e 
r eview tea m co n sultants with specialities i n areas to he 
evaluated. 



t&) Following completion ofan inspection, an exit-conference 
shall be conducted with o n e o r mo r e r epresentatives of t h e 
program's management. A n o r al su m ma r y of t h e find in gs shall 
be presented at the exit-co i ifeience. The Division shall pr ovide 



t+teTV 



-•r og r a m D ir ector with a wri t ten report of t h e findings withi n 
20 wo r king days following the inspection. — Th e P r og r a m 
Director shall h ave ten working days from the receipt of the 
r epo rt t o r es p o n d w i th a plan or repor t which describes the steps 
take n to r emedy a n y o b se r ved deviations from certification rules 
co nta ine d in thi s Subchapte r . 

Authority G.S. 131E-I69. 

.021 1 REVIEW TEAM: REVIEW PROCESS 

ttr) The re view tea m may include persons from existi n g 
certified p r og ra ms w i th specialities in program ai - eas to be 
i nspec t ed, (e.g.. physician, P r ogram Director, exercise spec ialist 



or coordi n ator, dietitian 



-or — nutritionist, registered — n u r se, 
psychologist, and any other appropriate consultants). — Pe r so n 



sul " ) j ect to occupational licensi n g (phys i c i an, psyc hi at ri st, et c.) 
must have a c urrent. valid North Carolina licens e o r r eg i st r a tio n. 

(fr) The team of consul t ants will incl u de s t aff fr om e xis t ing 
certified Ca r dia c R e hab i litation P r og r a m s. All pe rs o n s ass i gned 
to r eview tea m s a re aut h o r ized r epre senta t ives of the Departmen t 
w h e n e n gage d in an i n spection of a ca r d i ac re h ab i l i tat i on 
pr og r a m sc he duled i n acco r dance with Rule .0210 of this 
Subc h apte r . 

to If the service of a physician reviewer cannot be obtained 
t o p ar tic i pate in a program review, the Division review 
coordinator wil l make appropriate ad j ustments in review team 
composition. 

(xH The review team will observe the program in operation 
and in t erview staff membe r s to assess the operation of the 
program. 

tei Eac h r ev i ew co ns ul t a n t w ill su bmit the i r worki n g copy of 
t he review l orm to t h e r eview coord in ato r at the completion of 
t he review. T h e r eview coo r d i na t o r w i ll su m marize the findings 
an d r e p o r t in w ri t in g to the p r og r am within 20 working days. 



.0210 INSPECTION 

titi Any Cardiac — Re h ab il i t a ti o n P r ogram a p plying for 
certification shall be inspected b y representatives of the Division 
p r i or to the issuance of a ce r ti f icate. 

fbl Any Cardiac Rehabili t ation P r og r a m cert if i e d b y th e 
De p a r tment may be inspected by autho r ized rep r ese n tatives of 
the Div i sion at any time during the p r ogram's bus in ess hou r s. 
I )n-sile i ns pec t i o n s shal l b e co n ducted as necessa r y to ce r t i fy 
c tim p liance — or — co n ti n ued — compliance — vmh — cert i f i cation 
requ ire ments. Inspections m ay b e unannounced. The pur p ose 
of a n y i n spection w i l l be ex plaine d or summarized with the 



Authority G.S. 13IE-I69. 

.0213 ADVERSE ACTION 

If a program is found i n s i g ni ficant noncompliance with t h e 
mles co n ta in ed i n this Su b cha p ter and G.S. 1."^1E. Article 8. the 
Division sha ll e i the r issue a provis i onal certificatio n , deny a 
request for full certification, suspend a program's certitication. 
or revoke the program's cert i tication . Co mp lian c e failu r e w h ic h 
i eopardizcs the he a lth, s af ely a n d welfa r e o f any p atie n t, a n d 
r emains u n co rr ected as s p eci f ied by th e Division, may be 
suffic i e n i cause fo r t h e de ni al o r r evocat i on of certification. 



14:5 



NORTH CAROLINA REGISTER 



September /, 7999 



376 



^SB^^^^^S^^ 



PROPOSED RULES 



Authontx G.S. I3IE-169. 

.0214 PROCEDURE FOR APPEAL 

A Caidiac R e habilitation P r og ram m ay ap p eal a n y d e cision of 
th e D i v i s i o n to d en y, revoke, sus p end, o r amend a ce i l i ficate by 
m ai< in g such a n a pp eal i n acco r dance with G.S. 150D and 10 
N CAC I B .0 2 00 . 

Authontx G.S. niE-169. 

SECTION .0300 -PERSONNEL 

.0307 COMPOSITION OF STAFF 

The followi n g pe r sonnel must b e on the staff of a ce r tif i ed 
Ca r diac Rehabil i tation Program : — Tlie prog r am staff must 
include a program dii ' ector. m ed i cal — director, d i eti t ian or 
nu tri tio n ist. — psy c h ologist — or — psychiatrist. — voca t io n al 
r eha bilit ation counselor, exercise specialist/coo r di n aio i a n d 
p a ti en t educator : — One .staff mem b er shall n o t have primary 
res p onsibili t y for more tha n two staff positions. 
t+1 Staff P osi t i o ns: 

(al P r ogram Direclorserves as the ad m i n istrator of 
the certified prog r am, supervises t he staff and 
directs all facets of the total program. 
fir) Medic al — Director is the consultant on all 
medical — aspe ct s of — the — program — and — is 
responsible for the medical supervision of all 
testing, treatmen t s, pi ' escriptio n and therapy 
p r ograms of p ati e nt s i n addition t o developing 
emergency procedu r es and atte n ding to t h e 
equipment. — m edication. — and — adequacy — of 
pei ' sonnel. including the physicia n s . — This 
person is also tl i e liaison wi t h t h e med i cal 
community. 
tc) Exe r cise specia l is t /coordinator is responsible 
for design i ng and supervis in g the exercise 
p r ograms in co n sultat i o n with the medical 
directoi'. — Duties also include implementatio n 
of the exercise prescription. Daily heart rate, 
attendance i - eco r ds and othe r information are 
collected and m a i nta i ned on a regular basis by 
thi s staff me m be r . 
fdl Psycho l og i s t — or psychia tr ist — analyy.es — the 
psychological n eed s — of the — pat i ents — and 
counsels or refe r s patients for tre at m e n t. Th e 
r elaxation — program — fs — e i the r — led — by — the 
p sychologist — or — p sychiatrist. — or — the 
psychologist o r psychiatrist has p r ovided 
in -se i" vice I r aini n gfor other staff to ca rr y it out. 
The psychologist or psychiat r i st also provides 
consultation to the — staff mem b ers about 
suggested ways of deal i ng with emo t ional and 
psycholog i cal ad j ustments of the patients. 
(e) Dietitian o r nutr i tionist obtai n s diet hi s t o r ies, 
a n alyzes pat i e n t diets, and cou n sels patien t s 
and other persons des i gnated by the patient on 



(f) 



diet modifica t ion. 

Vocatio n al rehabilitati on ct n i n seloi ' sc i ee iistfTc 

p r ogram — patients — using —a — v ocational^ 



North — C a ro li n a 



termine -ihosc^-hn- 

•sied in-tfnrserrrces erf the 
Division — of — Vc i cationa l 
-The 



f2l 



Rehabilitation — S ervices — (i^ VftS >r 
counselor develops the vocatii iial assessment . 
presc r iption, and inte r ve n t i on strategies, aii d 
p rovides counselin g^- a n d othe i — ser vices as 
appropriate. — AH se r vices p r ovided must he 
necessary t o achieve the vocatio n al objectives 
of patients w h o become clients of DVRS. The 
counselo r a l so attends staff meetings i n whic h 
DVRS clien t s are to be d i scus se d, counsels and 
p rovides fo l low-u p to c li e i us at the p r og r a rrr. 
and participates in Ti t h er p rog r a rrrat'tTTTtn-'s-. 
Pat i e n t educator organizes the cdrtcatioTrat 
as p ects of the progra m , i n c lu ding educational 
materials such as h a n douts, brochures, a n d 
new sle t te r s. — The pa t ient educato r i s also 
responsi b le — for — the — coo r d i na t io n -of — ttrc 
education — l ectures, mini-sessi ons- — patient 
counseling, and feedback sessions. 

Addi t io n al Role s: 

fa) Exercise — technologist — wo r ks — u nd e i — the 
direction — of the — medic a l dire ct; n ' a n d -rs 
r espons i ble for the ad iTiini s ir alio nnf -t he g r aded 
exerc i se tests, inc lti dmtr -t he o p e r at i o n - 



^ 



i>l lllcS 

treadmill. — e lect r ocard i ograph — (EKG). 
oscil l osco pe , and other laborato r y tests. 

th) A tt ending — physician — strafi — b e on-site and 
ava i lable throug h o u t t he the r apy i ncluding the 
s p ecific warm-up. stimulus and cool-d o ui i 
phases. 

fd Registered n u r se se r v ' es as tc'acher." acts as 
liaison person to other disciplirtesra^sists with 
medical emergencies, main t a i ns emerge n cy 
equipment, h el p s t o assess, plan and evaluate 
interdisciplinary — base — plan — of — care; — and 
maintains — vital — ri-gn — re co r d s — arrd 
symptomatology. 



Authority G.S. I31E-169. 

.0308 MINIMAL EDUCATIONAL STANDARDS: 
STAFF POSITIONS/ADDITIONAL ROLES 

tai S t aff Pos i tio n s : 
Hi The — Program — D i rector — of- a cer t ified — Cardia c 
Rehabil i tation Prog r am must meet the requ i remen ts-of 

(T*r) b e a n ACSM (A m e rican- College trl-SpoTis 
Med i c in e) c er tified p r og r am directo r o r an 
ACSM ce r t i fied exe r c i se s p ecialist, and hc M 






m 



3rdT:tc~h le support; or 
lasters or doctorate decree 



377 



NORTH CAROLINA REGISTER 



September /, 1999 



14:5 



PROPOSED RULES 



) 



in nursing, exercise physiology, or another 

health — pr ofe s sio n . — 866 — hours — of — cardiac 

reliabilitatio n ex p erience, and be ce r tified i n 

basic cardiac life su p port. Prog i am Directors 

not meeting these requirements who were 

employed — by — the — pr og r a m — prior — to — the 

De c e m be r I. 198 9 , effective date of these 

Rules m ay con t inue in their present position. 

and — are — encouraged — to — seek — continuing 

educa t ion in appropriate subject matte r . 

ib) Tlie medical director of a certilled Card i a c Rehabilitation 

P r og r am must meet the requirements of either Subparagraph 1 1 ) 

or (2) of this Paragraph: 

iVi have a med i cal deg r ee, be li c e n sed to practice 
medicine in North Caroli n a, be a board certified 
i nte rni st or ca r diologist, and have experience in the 
medical — su p e rv is i o n — of — Ca r diac — Rehabilitation 
P r og r a m s, or have recent experience i n emergency 
p atient ca r e; o r 
(^ have a medical deg i ee. be lice n sed — to pract i ce 
■ ledic in e i n No r th Carolina, have ex p erience in 
electrocardiographic interpretation a n d — in graded 
exercise testing; and be ce rti fied in basic cardiac life 
support. 
ttr) The exercise specialist or coordinato r of a certified 
Ca r d i ac Rehabilitation Program must meet the r equi r e m e nts of 
eithe r Subparagraph ( I ) o r (2) o f th i s Pa r ag r a p h : 

til be certified as an exercise special i st o r p r o gr a m 

m directorby t he Ame ri can College of Sports Medicine; 

and b e certified i n b asic cardiac l i fe s up po r t; or 

t2) have a bac h elo r 's deg r ee o r certification in a health 

f ield ; have at least one year's previous experience in 

working — wrth — adtrtt — fit n ess — and/or — Cardiac 

Rehabilitation P r og r a m s; be certified in senior life 

saving (if a swimming program is offered); and be 

cert i fied in ba si c cardiac l ife support, and supervised 

by the pro gr am director who has ACSM ceilification 

as a n exercise specialist or program director. If the 

p rog r am does n ot have an ACSM certif i ed exercise 

spec i alist o r p r ogram director on s t a f f and significant 

weaknesses a l^ e identified in this program component. 

th e p r og ra m m ay be required by the D ivi sio n to seek 

q u alified con s ultation on an annual or semi-annual 

basis. 

(tf) The dietit i an o r nutritionist of a c ertified Cardiac 

Rehabilitation Prog r am must meet the requirements of eithe r 

Subparagraph ( I ) o r (2) of this Paragraph: 

Hi be a dietitian registered by the Amei - ican Dietet i c 

Assoc i at i on, and be certified in basic cardiac l i fe 

support ; or 

t2i have a bachelor's o r advanced degree in foods. 

nutrition, or fo o ds and nutrition, and a one yeai - 

internship in a hospital practicing therapeutic dietary 

^ counseling; a n d b e certified i n b a s ic cardiac l i fe 

' support. 

tej The psychologist o r psychiatrist of a cert i fied Ca r dia c 
Rehabil i ta t io n P r ogram must meet t h e requireme n ts of e i t h e r 



Subparagraph ( I ) or (2) of this Paragraph: 

(+1 b e a l i censed p r act i ci n g psychologist in No i tl i 

Carolina (docto r a l level) o r a lice n sed psychological 

associate mon i tored and supervised by a licensed 

practicing psychologist; have a minimum of two years 

of acceptable and appropriate expe r ience, and be 

certified in basic cardiac life support; or 

t^ b e a hoa r d ce r tified psyc hi a tr ist licensed to practice 

m edici n e i n No r th Carol in a, have a minimum of two 

y e a r s of ac c eptable a n d appropriate professional 

experience, and be certified in bas i c cardiac life 

support. 

tf) The vocational rehabilitation c o uns el o r of a ce r tified 

Cardiac Rehabilitation — Program must — b e a rehabilitati o n 

counselor with a master's degree in rehabilitation counse l i n g o r 

a related field, or have a bachelor's degree and be appropriately 

qualified to provide vocational rehabilitation services. — The 

vocational r ehabilitation counselor must be certified in basic 

card i ac life support. 

tgi The patient educator of a certified cardiac rehabi lit ation 
program must either have an R.N. degree or a bachelo r 's deg r ee 
in a health field (nursing, health and sport scie n ce, p h ysical 
therapy), have had basic coursework. training, and experie n ce in 
patient education with an adult popula t ion, and be certified in 
bas i c cardiac life support. 

fti The exe r cise lest technolog i st of a ce r tified card i ac 
re l iabilitation prog r am must meet the requirements of 
e i ther Sub p a r ag r a ph — (A). (D), or (C) — of — this 
Parag r aph : 

(A) Be certified as an exe r c i s e tes t tec h nolo gi st by 

the American College of Sports Medici n e, and 

be certified in bas i c cardiac l i fe support: or 

(©j Be a registered nurse or have a bachelor's 

degree — m — a health — field, — have — a — basic 

knowledge and experience in g r aded exerc i se 

testing and exercise electrocardiography, and 

be certif i ed in basic cardiac life support; or 

(O If not certified as stated in Subparagraph (A) of 

this Paragrap h or possessing a degree as stated 

i n Subparagraph (B) of this Paragraph, the 

med i cal directo r m ust decl a re that the person 

has compete n cy of training and/or experience, 

have — b a si c — k n owledge — and experience — m 

g r aded — exe r cise — testing — and — exercise 

el e ctro c a r d i og rap hy, and b e certified in basic 

cardiac life su p po r t. 

t21 The attend in g — physician of a — certified — cardiac 

r ehabili ta t i o n p r og r a m mu st have a medical de gre e, be 

li ce n sed — to — practice — in — North — Carolina. — have 

co m p e te n cy to direct other staff in a — m edical 

emergency, a n d must be approved, in writing, by the 

medical director. 

t3l The — registered — n u r s e — of — a — certified — ca r d i a c 

rehabilitation prog r am must b e l i censed to practice 

profess i onal — n u r s in g — m — North — Carolina. — h ave 

co m petency — to — as si st — other — staff in — a — medical 



14:5 



NORTH CAROLINA REGISTER 



September /, 1999 



378 



mmimsfm 



PROPOSED RULES 



e m e rg e n cy. — be — compete n t — m — b asic — IIKG 
inler p ielat i o n s. have at least o n e y e a r expe r ience in 
ca r diac — r eha bii ilal ion — or — equiva l e n t — (i.e.. 
co r onary/ci ' iticalca i' e n u r se >. a n d h e ce rti f i ed in basic 
card i ac lite sup p ort. 

AurhorinG.S. 131E-J69. 

SECTION .0400 - PROGRAM ADMISSION CRITERIA: 
PATIENT ASSESSMENT 

.0407 ADMISSION CRITERIA 

Pa t ients e n te rin g a cert i lled Cardiac Rehabilitation Program 
must have o n e o r a combination of the following: 
Hi Myocardial infarc t ion : 

tcc) A post-myocardial i nfa r ction patient may ente r 
a prcigraj i i a n y t i me at t he disc r e ti on of tlie 
med i cal director and referral from a pe r s on al 
p h ysician. 

tH The r e — mttst — be adequate — control of 

complications, i.e.. angina, congestive h ea r t 

failure, a rr hythmias, etc.. acco r d i ng to the 

medical direct o r and the r eferr i ng physician. 

(2) Angina pectoris: r ecent changes in medica t io n for 

a n gina control are permissable at the d i sc r etion of the 

patient's pe r so n a l phys i c i a n. 

(fH Post-operative — cardiovascular — su r ge r y rrr 

i nterventional — pr ocedu r es. — 'rcr, — C.ADG. — PTC A. 
valvular, cu n gei iil al t ir pe r ipheral surgery : 
tai A post-operative cardiovascular surgery pat i ent 
may enter a prog r am at any time at — ttrc 
d i sc r eti o n of the m edical director and refe r ral 
f r om a pe r sonal physician. 
A — p osl-opei - jiive — va l vula r. — congenital 



m 



nr 

p e ri p h e r a l obstructive surgery pat ie nt ma y be 
admitted with the admiss i on date being at the 
discret i on of t h e — referr i ng physic i an — and 
m edical d ir e ctor . 
t+> I lypertension : patients with low func t ional capacity or 
a- specified n eed t o main t ain therapy may be admitted 
to the program. 
(5) Ar r hythmias: 

(tr) Patients — with — ser i ou s — a r rhythm i as — and/or 
conductio n defects m ay be admitted to the 

fbl Pace m ake r patients wit h any of the diagnoses 

co n tained i n thi s — Rule and/or decreasing 

functional capacity may be admitted to the 

program. 

tfr) Ot h er co n d i t i ons which may b e conside r ed grounds 

fo r admissio n include. — but a r e not limited — ttr 

card i o m yopathies, valvular heart disease, ca r d i ac 

t r anspla n t. COPD. dia b etes, and disabli n g rena f 



disease. — Appropria t e assessment, pre script ive 
therapeu ti c mod if ications must be docu m e n ted. 



and 



n each" 



Ainhorin G.S. 13IE-169. 

.0408 PATIENT ASSESSMENT 

I'pon admission to the Ca r d i ac Re l'i a hiHlatiorrPrograr 
pa ti e n t m ust have a medical record ttcvdoped ■vvtrrrh" hi c ktdes 
writte n documentation of the disabli n g cui i diti oTr antf— an 
asse ss me nt. This assessment must incl udr: 
(4i Medical Assessment: 

fal Ca r d io vascular evattnttron — as — ttr — pr ese nt 

nd— condrtTOn — a n d a 
Tif— the — p atie n t's — hist 



m 



oi 



(41 



(51 



discharge — summary 
hospitalization: or 



ttrl Statement bv ' r eferri n g physicians as to p r ese n t 

Laborato r y Assessme n t : 

ta) Rest i ng 12-lead electroca r d i ogram: 

(b) Graded ex erci se irst — -wTttr 12-lea d 

electrocard i ogram ; 

(r1 Blood chem i stry to include total cholesterol, 
high density lipoprotein (HDL), tr i glycerides, 
and glucose; 

measured or predicted equiva lcrtts-tMET^ 
(ei Pulmonary func t io n studies, if indicated; and 
tf) Height. we i g h t. -pcTccnt'body-titt.-tmd ideal 

Dietary Assessment : 

fal Nu trit i on history cnnt-ai ning socio-ec o no mi c. ^ 

medical, anthropi i me tric . d i e t a r y a nd attitudina^ 

information; 
fW W r i t te n t h ree day diet reco r d: 

(c) Review of medical history and a s sessment. 
recen t serum lipid analysis, and anthropomet r ic 
a n alys i s: 

{&) Nutrition i n le i Aiew w ith p at i e nt and o th e r 

tc) Behavior survey considering frequency; 

motivation, — location — and — im p ed i m en ts — to 

eat i ng. 
Psy c h ol ogical Assess m ent : 

ttr) Psychological interview and questionnai r e: and 
fir) Screening forpsychopathology and heha\n ri a l 



dimensions — suc h 
depre ss i on, a n d Ty 
'Vocational Assessment : 
tn) Vocati on al qu e s tioi 
vocational — status. 



-as- tr-^ftttte-trait anxiety, 
hehavioraf pattern. 

jTre ttTdetermine current 
Tlescription — nt — physical 



tirking condit 
psychological demands -as—pc rceived by the 
patient; and 
(fr) 'Vocatio n al — questionna ir e — or — inter x'irt'i — to 
dete rmi ne de m og r ap hTc- ;mci -financiafdata. 
establish proper counselor/clicntTxHtttionship; - 
complete agency docum en tatio n to - assess^ 
eligib i l i ty for agency sc rmT s. a n d tn ttvsrss 
jgnnstic "proce 



379 



NORTH CAROLINA REGISTER 



September 1. 1999 



14:5 



PROPOSED RULES 



t hose i ndividuals w h o apply lor vocational 
rehabil i tatio n se r vices. 

f\uthority G.S. J31E-169. 

SECTION .0500 - INDIVIDUAL CARDIAC PATIENT 
REHABILITATION PLAN 

.0506 TEAM COORDINATION AND STAFFINGS 

(a1 A mult i -discipl in a r y team approach is used to im p le men t 
e ach pat i ent's Caidiac Rehabili t ation P r og r am. Tl ii s team brin gs 
togethe r all of the disc i p l ines involved to remedia t e ca r d i ac risk 
factors and carry out therapy. 

tb) €>n — the basis of their assess m ents. — the — ca rdiac 
rehabilitation staff shall decide upon the most app r o p r i ate mea n s 
of intervention for each patie n t. W it hin fou r weeks of entry i n to 
the program, a p r esc r iption shall be develo p ed by each staff 
memb e r . 

tx) The team staffing r eport, at a minimum, shall include a 
coordinated t he r a p eu ti c pl a n of exe r cise therapy, diet therapy, 
p s ycholog i cal se r vices, and vocatio n al rehab i litatio r junseling 
a n d se r v i ces. Th i s re p o r t m ust be sent t o the p atient s p e r s on al 
a n d referring physicians, if a n y. with a co p y maintained in the 
medical r eco r d. 

(tf) AW — mu lti -dis c i p li n a r y — staff (exe rci se — coo r di n at or , 



psychologist, a n d nu tri t i onist), w il l attend a minimum of one 
cardra c t he r apy sessio n p e r week and on e patient staffing pe r 
m onth. The v oca t io n al r ehabilitation co u nselor assigned to the 
yr og ra m shall at t end at le a st those staffings at which VR clients 
a r e discussed. 



Authority G.S. I3IE-I69. 

.0507 CARDIAC THERAPY 

(a^ U n less medically contraindicated. each individual's 
r e h abil i tation pl an shall i nclude : 

t+l Type of cardiac therapy: gymnasium (walk/Jog) 

prog r am, swimming (walk/swim), bicycle e r go m etry, 

aim eigometry, circuit training, o r treadmill walking 

prog r am: 

(^ Intensity: 60 to 85 percent of symptom-li i Tiited heart 

t3l Duration : — at least — 45 — m i nutes du r at i o n — with a 
mini m um of .' ^ minutes at t h e stimulus phase and 
r e m aining time in warm-up/cool-dow n : and 
t4l Fi ' eque ii cy: minimum of three n o n -consecutive days 
per week. 
tbi At the d i sc r etion of the medical d ir ecto r , the pat i ent may 
he monito i- ed c o n ti n uo u s l y or intermitte n tly tfirough t h e u se o f 
electrocardiography while perfoi iii ing the cardiac the rapy 
desc rib ed in Parag r aph (a) of this Rule. 

(r1 There shall b e an attending phys i cian on-s it e a n d availa b le 

before a cardiac therapy session begins with the specific 

up. stimulus and cool-dow n phases. In the event that a 

physician is not availa b le, the session shall be suspended or an 

ed u ca ti onal progra m m ay b e subst i tuted fo r card i ac th erapy^, 

(d1 A staff to patient ratio in the cardiac therapy sessions shall 



fc 



b e at least 1 : 12 fo r all programs. 
Authority- G.S. B IE- 1 69. 

.0508 DIET THERAPY 

Each i ndividual's program shall include the following dietary 
se r v i ces : 

t+) Inteipreta t ion and f eedback of nutrition assess m ent to 

pa ti ent and designated other person: 
d) Patient and othe r designated person counseli n g o n 

nutrition — for — good — health. — food — selection — and 

preparat i on, with p rescription of a therapeutic diet if 

necessary: 
(5) Eating behavior modification when appropriate: and 
(+) Identification of a weight goal and weight reduction 

classes if necessary. 

Authority G.S. 1 31 E- 169. 

.0509 PSYCHOLOGICAL SERVICES 

Eac h — i ndividual's — prog r am sliall — include — the — following 
psychological se r vices: 

Hi Interpretation — and — feedb ac k — of — psychological 

assessment to the pa ti e n t. 
t^ Recommendations concerni n g an appi ' opriate plan of 
counseling oi ' therapy (on-site or referral) which may 
include one o r mo r e of the following : 
iix) i ndividual or g r oup therapy; 
ftr) st r ess management: 

(d1 smoking cessation; and 
te) behavior modification. 
t?r) The psychologist shall personally conduct sess i o n s , or 
instruct - other sta f f to co n duct sess i ons, so that 
relaxation or stress ma n ageme nt is offered at least 



Authority G.S. 13IE-169. 

.0510 VOCATIONAL REHABILITATION 
COUNSELING AND SERVICES 

Each i n dividua l who n eeds vocational rehabi l itation services 
a n d who meets the No r th Carolina Div is ion of Vocat i onal 
Rehabilitatio n el i g i bili t y criter i a shal l ha v e a prog r am that 
i n c l udes : 

Hi vocational — counseling, — to — i nclude — adequacy — of 
functiona l capac i ty fo r vocational and avocational 
ac t i vi t i es : 
(^ pr ovis i o n of vocational evaluatio n and vocational 

trai n ing fo r designated i n d i v i dua l s: 
t3i J ob de v elopment and place m ent service fo r el igibl e 

clients; 
(4) intervention with employers, a s n eeded, to facil i tate 

client's return to employment; and 
(51 othe r vocational rehabilitatio n services as appropriate. 



Authority G.S. 13IE-169. 



14:5 



NORTH CAROLINA REGISTER 



September /, 1999 



380 



■■IIULIILlll.,nB 



PROPOSED RULES 



.0511 REVIEW 

To e n su r e that the t reatment presc r ibed in each ind i vidual's 
planned — prograjn — is — approp r ia t e. — formal — i n te r d i sc i plinary 
d i scuss i nns on patien t prog r ess shall he co n ducted on a monthly 
basis. 

Atirhorirx G.S. I3IE-169. 

SECTION .0600 - PROGRESS EVALUATION AND 
FOLLOW-UP 

.0614 PROGRESS EVALUATION AND FOLLOW-UP 
PROCEDURES 

P a t ie n t follow-up s ha ll i n clu d e : 

t+) Following the — implementa t ion — of each — cardiac 
patient's rehabili t ation pla n , r o u t ine m on i toring of 
pat i en t progress shall be acco m plished. Changes t o 
each pa t ient's plan shall be made as app r o p riate, based 
u p o n evaluations. 

t^ Progress evaluation and other informa ti on pertaining 
to each patient's participation in the prog r am shall be 
com m u ni ca t ed with the staff. 

(3) Reports of progress shall be sent to r eferring and 
personal physicians, if any. at regular follow-up 
int e r vals, defi ne d as three, six. and 1 2 mo n ths aft er 
e n t r y. If the patient continues in t he program after 1 2 
months, the results of annual re-evaluations should 
al so be r e p orted to the referring physician. 

Aiiihonn- G.S. 13IE-169. 

.0615 MEDICAL FOLLOW-UP 

Medical follow-up procedu r es shall include : 

t+l evalua ti on of pa t ient progress in funct i o n al capaci t y 
through examinat i o n ofg r aded exe r cise testing (GXT) 
data at regular follow-up interva l s. If a GXT i s n o t 
done, the reco r d must contain documentation of the 
r easo n it was defer r ed; 

tJ) consultation — with — professional — staff — r ega r d in g 
pr og r ess made by patients towa r ds sp e c i fied goals 
(e.g.. functional ca p ac i ty, sm oki n g cessa t ion, dietary 
mod i ficat i on, we i g h t and lipid control, psychological 
status, vocatio n al s t atus); 

(5) c o n sultat i o n with staff rega r di n g pat i ent medications; 
and 

Hi consu l tatio n rega r d i ng alter n ate med i cal o r su r gical 
interven ti o n (e.g.. cathete r ization, surgery). 

Aiithorin G.S. I. ^ IE- 1 69. 

.0616 CARDIAC THERAPY FOLLOW-UP 

Ca r diac the r apy f c ^llow-up pr ocedu r es sha ll in c lu de : 

ffi moni tilling — of — patient — adhe r e n ce — to — exercise 

prescrip ti on by systematic examinatio n of pat i en t 

re co r ds ( i ntensity and frequency of ca r d i ac therapy 

se ssions) at monthlv inter%a fs . and docume n tation of 



f eed b ack to the patient; 
t^ p e ri od i c r ev i ew of the exerc i se p r e scriptioTt- for 

appropriate i nt ensity and duiation; and J 

t^ c o n sul t a ti on with — medica l director -on — ex e r c is* 

prescription changes wheuTiccdrtftireT; irt -fof k i w-u p 

GXT's a n d change in medication) . 

Authorax G.S. I31E-169. 

.0617 DIETARY FOLLOW-UP 

Dietary follow-up p r ocedures shall i nclude: 
f+1 Patient records of w^eigh t at least weekly and as a 

component of stress test protocol at regular follow-up 

intervals; 
{^ Rev i ew of m edical status resul t s, as well a s lipid b ody 

comp o sition and dietary s t a t us resul t s at r egukir 

follow-up intervals; 
f3l Referral and follow-up to ind i\n dual oi - group -diet 

pr og r a m to fac i l i tate achievement of dietary goals. 

especially we i ght reduction; 
t+) Periodic — m o n itoring — of the — incorpo r at i on — and 

maintenance of a p propriate dietary modi frratirms-. 

Aiahorin G.S. 131E-169. 

.0618 PSYCHOLOGICAL FOLLOW-UP 

Psychological follow-up must - in clud e eva l u a ti o ns - m ade at 
r egular follow-up i n tervals to dete i iiirnrth e e x te ntlo \\ hi ch ih t ^ 
p atie n t has bee n able to m ai nt a in need e d ch anges i n l i festyle a n a | 
coping skills. — This may he accomplished by interview or 
psychometric assessment. 

Ainlwnn G.S. I3IE-169. 

.0619 VOCATIONAL REHABILITATION 
FOLLOW-UP 

Vocat i onal re h a bi l it a ti o n follow-u p on sponsored clients shal l 
in clud e: 

t+l Counseling sessions to discuss pr o gr ess made i n t h e 

r ehabi li tation pla n; 
(^ Co n tact w it h c lie nts (and e m p l oyer, if needed) after 

return to work or exit from the program: trrtd 
f+i Other app r opriate vocationa l re ha bil itat i o n se rvi c es. 

Autlwiitx G.S. I3IE-I69. 

SECTION .0700 - PROGRAM DISCHARGE 

.0706 CRITERIA FOR DISCHARGE 

Six to twelve months is usually necesvarx'-tor the "significrmt 
rehabilitation of most card i ac patient s."UptTn- delibe ratioTi and at 
the d i sc r e t ion of the re h ab i l i tation pmgraTTT-staff.-tt pnticntmay 
b e d i scharged after sa t isfacto r y imp nn cTnen t or a min imum of^ - 
s i x months part i c ip atio n if app ropri at e le v els a r e m et fo ^ 



rttts; -pihysTcaf- fitness and 



education. 



381 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



PROPOSED RULES 



Authorin G.S. 131E-169. 



^OlQl DISCHARGE PLAN 

^ A Final decis i on is made [ i y thecai ^ diac rehabili t ation staff t o 
discharge tl ie p atient from the program into anotiier appropriate 
pr og r am (home. YMCA. Cardiac F i tness/Graduate, or other). 
T hi s d i schai - ge should be docu m e nt ed and communicated to the 
referring and pe r s on al physicians, if any. 



t+&) ai l re cords of each discipline's paiticipation in the 

patient's therapeutic pla n; 
(i+) discharge plans prov i ding fo r post-dischaj-ge pi ' ogra iii 

continuity and follow-up as appropriate; and 
(+2^ miscellaneous — records — desirable — for — pr og r a m 

continuity. 

Authorises. I31E-169. 



Authorin- G.S. 13 IE- 169. 



SECTION .0900 - EMERGENCIES 



SECTION .0800 - MEDICAL RECORDS 

.0806 POLICIES AND PROCEDURES 

Each cer t ified Ca r diac Rehabilitat i on Program shall have 
p olicies and p r ocedures which shall be implemented to provide 

t+1 m ai n te n a n ce of a co m plete, accurate and organised 
me dical record for each patie n t admi t ted to t he 
program; 

confide n tiality of r eco r ds ; 

accessibility oi ' non-a c cessibili t y of medical record 
information — to — th e p atie n t. — prog r am staff and 
non-employees; 

reten t ion a n d d i sposition of records in accordance 
with the N.C. Statutes of Limitations, G.S. 1-15. 1-17. 



m 



t4l 



Authorin- G.S. 131E-J69. 



♦ 



0807 RECORD REVIEW CONSENT 

Then 



.0901 EMERGENCY PLAN 

A written plan shall be established which is sufficiently 



flexible to handle 



medical 



, i - g^-oi - j of each patie n t mu st c on ta i n a statement sig n ed by 
the patient which r eads as follows : — "I unders t and that in 

accordance with N.C. Ge n eral Statute 1 .11 E- 1 70. 1 have the right Authority- G.S. 1 31E-169. 
to ob j ect in w r iting to a review of my record or r ecord 
infor m at i on by t he Division of Facility Services representatives 
during sta t e ce r t ifi catio n inspections and by an o bj ec tio n m 
w r iting I may proh ibi t the in spection or release of my records." 

Authority G.S. 131E-I69. 

.0808 CONTENT OF MEDICAL RECORD 

fa) A l l ent i ies in the record shall be legible and sig n ed by the 
individual m aki n g the e n try with a signature, title, and dale. 

(tr) The patient's na m e must be recorded on each p age of the 
record. 



ixi n ie to nanciie any emergencies. Al l a r eas of the premises 
pertinent to prog r am operation must be i n cluded. Tl i e plan shall 
address the assignment of personnel and availability of 
equipment which is subject to use in an e m e rg e n cy. All patients 
shall be informed during orientation that s t aff supervision ceases 
when the patient exits the program "site". 

Authority G.S. I31E-169. 

.0902 EMERGENCY EQUIPMENT 

The following equipment and supplies must be available and 
operable i n an emergency: 

Hi suction equipment (poitable); 
defibr i l l ator (portable); 
intubation equipment; 
drug kit; 

oxygen tank supply; 
regulato r and m ask or n asal cannula. 



(5) 



.0903 PERSONNEL 

fal F o r out-of-hospital cai ^ diac rehabilitation programs: Two 



td The medical reco r d shall contain at least the following : 

(5) 



patient i de n tificat i on data ; 
medical history and hospital discharge summary ; 
g r aded exercise data- 
record of oxygen uptake where appropriate; 



reco r ds of blood chemistry analys i s i nc l uding l i pid 

pi'cifile; 
(fr) i n fo r med consent to participate in t he programs; 
■ fii r eports of physical examinations. 

(*) progress notes and response to the therapeut i c plan; 
t9l vocational questionnair e . 



icai personnel — must be present during the warm-up. 
stimulus, and cool-down phases of the cardiac the r apy sess i on. 
The m edical personnel must consist of th e a t tendi n g p h ysi c ia n 
a nd at least o n e of the fo l lowing qual i f i ed perso nn e l: reg i ste r ed 
nurse, physic i a n , physician's assistan t . The o p tio n s a r e : 
(+) two M.D.'s. or 
{i) one M.D. and one Phys i cian's Assista n t licensed to 

work under that docto r , or 
(5) one M.D. and one registered nurse. 
fb) For in-hospital programs : 
tii The phys i cian must be in-house but not involved i n 
such activities as surgery, cardiac cath. etc. I n o t he r 
words, he/she must be immediately avai l able by so m e 
direct emergency contact system. Tliis system must 
b e tes t ed at regular intervals. 
t^ Backup code- b l u e team response must be available. 
tf*1 O n e ce r tified Adva n ced Cai ^ diac Life Support (ACES ) 
staff m embe r able to implement approved ACES 
protocol s hould b e p r e s e n t at the exercise site. 

Authority G.S. 131E-169. 



14:5 



NORTH CAROLINA REGISTER 



September 7, 1999 



382 



PROPOSED RULES 



.0904 EMERGENCY DRILLS 

A w i-i tte n lec ni d of innn t h l y d r ills should be documented. I n 
the record, a dai l y review of the crash cart equipment and a 
mo n th l y drug i n ventory is required. — T T ie d ri lls should be 
d ir ected, a n d th e effectiveness of the dri ll s h ould be re v ie w ed, 
docu m e n ted, and s igned by. t he m edical directo r o r attendi n g 
physician. 



Aiitlwrity G.S. BlE-169. 

SECTION .1000 - FACILITIES AND EQUIPMENT 

.1001 PROGRAM REQUIREMENTS 

(tr) Fac i li ti es a n d equipment necessary fo r the delivei7 of 
each phase of the Cardiac Rehabilitation Program must be 
read i ly avai l able for use. 

{b) A w r itten prevent i v e ma in te n a nc e program shall be 
es ta bl ish ed to ensu re that all equipment is m aintained in safe and 
pr oper working order. 

(ri A quali t y assurance progiam must be p r ovided for 
periodic cali br atio n ol icsi equip m e n t which is in accordance 
with — m a n ufac t ure r s' r ecommenda t ions or other geneially 
acc e pted standards. 



AuthoritxG.S. I3IE-I69. 

. 1 002 GRADED EXERCISE TESTING LABORATORY 
EVALUATION 

Tbrc follow in g facilities and equipment shall be availa b l e fo r 
laboratoi7 evaluation: 

t+1 adequa t e space for physical examination and graded 

exercise testing: 
f2l i^^^tad-etectrocitrdrographic-eqtriprneriHTirexCTCTW 

testing: 
t3l oscilloscope for — ele c t r ocardiog r ap h ic — (ECO) 

monitoring or continuous reco r ding: 
t4i t r ead mi ll, b i cyc l e ergomete r . or a r m cra n k e r gome t e r: 
tfr^ sphygmomanometer. — b lood — pr essu re — ctrff^ — and 

stethoscope: 
tfr) e m e r ge n cy procedures, equ i p m e n t, a n d supplies as 

desc rib ed in Section .0900 of this Su b chapte r on 

emergenc i es: 
t^ anthro p ometri c — equipmen t — (skinfold — ca l ipe r s. 

stad i omete r and phys i cian's bala n ce scale): and 
(Xl sp ir o m ete r foi ' pulmona ry fu n ct i o n testi n g. 

Authority G.S. I31E-169. 

.1003 CARDIAC THERAPY 

The follow in g facilities and equ ip ment shall he available and 
ope r able fo r t h e cardiac tlie r apy progra m : 

trh gym n asium, m ult i purpose room, or li ' ack : 

(^ po r ta bl e CCG and oscilloscope: 

f3i sphygmomanometer. — bl ood — pressure — ctrff: — and 

(+) eme r ge n cy p i' ocedu r es. equ i pment, and supplies as 



described in Section .0900 of this Su h chap itT. 
tfr) large clock with a sweep sec (. TneHTtrnd-. 
tfr) r ecreational games e qu ipm e nt- if dee m ed n ecessar jj 

and appropriate by t he p rogra m " d ir ecto r o r xtkctv 

spec i alist. 



-T^R/ 



AiitlwimG.S. I31E-169. 

.1004 DIETARY PROGRAM 

T h e following facilities and equipmeii t'^ihaH- b e availabl e for 
the dietary prog r am : 

(+) Adequate space fo r interviewing and counseling: 

{^ Dietary tables a n d means of nut r ient a n alys i s: 

t^i A va i lahility of equipment or se r vice lo r-bit iod sc rum 

li pi d a n alysis: and 
{4) Appropr i ate — e duc ati o n a l — mater i als — for — patient 

•: thc-dict-ctr y consullali cin. 



AiithoritvG.S. I3IE-I69. 

.1005 PSYCHOLOGICAL PROGRAM 

The — f ollow in g — facilities — must — be — a\ ' ailable — for — tttc 
psychological program: 

Hi adequate space for i nterviewing, testing, counsel irrg 

a n d r elaxat i o n : and 
t^ access to refer r al so ur ces wit hi n the c omn n nTTty. 



Authority G.S. I31E-169. 

.1006 VOCATIONAL REHABILITATION PROGRAM 



I 



Adc 



lequale space — must be available — for the vocatio n a l 
rehabilitation program to allow for co n fide nti al i n te r v i ewing and 
counseling. 

Authority G.S. I3IE-169. 

SECTION .1 100 - GENERAL INFORMATION: 
DEFINITIONS 

.1101 DEFINITIONS 

The followinL! definitions shall apply throunhout this 
Subchapter: 

( I ) "ACLS-trained" means traininL' that is current in 
Ad\anceJ Cardiac Life Support, by the American 
Heart .Association. 



12] 
ill 

14] 
13] 
1^ 



"ACSM" means the American College of Sports 
Medicine. 



"Artie 



means Article 8 of G.S. I.^IE. 



"Cardiac Rehabilitation ProLirani" has the same 



meanint! as the definition in the Article. 



"Cert ill cat ion" has the same mcaninii as the definitio n 

in the Article. 

"DVRS" means the Division of Vocational. 



Rehahililali(>n Services, North Carolina Departmei' 
o'i Health and Human Services. 



(7) "Department" means the Norili Carolina Departmen t 



383 



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14:5 



PROPOSED RULES 






iii) 
19) 



10] 
LU 



:!3) 



(14) 



♦ 



Oli 



(16) 
07] 



(19) 
(20) 
(21) 



» 



of Health and Human Services. 

"Dietitian or nutritionist" means an individual who is 

licensed accordint; to G.S. 90, Article 25. 

"Division" means the Division of Facility Services. 

North Carolina Department ol Health and Human 

Services. 

"ECG" means electrocardiotiram. 

"Graded exercise test" (GXT) means a multistage test 

that determines a person's physiological response to 

different intensities of exercise or tjic person's peak 

aerohic capacity. 

"Maximal oxygen consumption" means the highest 

rate of oxygen transport and oxygen use that can he 

achieved at a person's maximal physical exertion, or 

functional capacity. This is usually expressed in 

METs. 



"Mental health professional" means an individual who 

iiL 

(a) licensed as a psychiatrist; 

(b) licensed as a psychiatric clinical nurse 
specialist; 



tc] 

id] 
le] 



licensed as a psychologist or psychological 

associate; 

certified as a clinical social worker; or 



licensed as a professional counselor. 
"MET" means "metabolic equivalent." a measure of 
functional capacity, or maximal oxygen consumption. 
One MET represents the approximate rate ol' oxygen 
consumption by a sealed indixidual at rest: 
approximately ,^.5 ml/kg/min. METs during exercise 
are determined by dividing metabolic rate during 
exercise by the metabolic rate ut rest. 
"Nurse Practitioner" means a currently licensed 
registered nurse approved bl !lK NC Board of 
Nursing and NC Medical Board to practice medicine 
as a nurse practitioner under the su pervision of a 
physician licensed by the Board. 
"Owner" means the legal owner of the certified 
cardiac rehabilitation program. 
"Physician" means an individual wht> js licensed 
according to G.S. 90. Article 1. by the NC Medical 
Board to practice medicine. 

"Physician Assistant" means an individual who is 
licensed and registered according to G.S. 90. Article 
L by the NC Medical Board to practice medicine 
under the superv ision ot a physician licensed by the 
Board. 

"Premises" means"site." 

"Program" means"Cardiac Rehabilitation Program." 
"Registered nurse" means an individual licensed by 
the NC Board of Nursing to practice as a registered 
nurse hi the State of North Carolina. 
"Risk stratification model" means a method of 
categorizing patients according to their risk of acute 
cardiovascular comtTlications during exercise as well 
as their overall prognosis. Risk status is related 
primarily to the type and severilv of cardiovascular 



(23) 



(24) 
(25) 



(26) 

(27) 
(28) 



disease. This ratin g takes into account how well the 
heart pumps, the presence oi^ heart pain symptoms 
and/or changes in the electrocardiogram during 
exercise. Guidelines concerning medical supervision 
of patients in cardiac rehabilitation programs which 
are based on risk stratification models are provided 
by: the American College of Cardiology, the 
American College of Physicians, the American 
Association of Cardiovascular and Pulmonary 
Rehabilitation, the American Heart Association, and 
the North Carolina Cardiopulmonary Rehabilitation 
Association. 

"Simple spirometry" means an analysis of air flow 
which provides information as to the degree and 
severity ot ' airway ohstructit)n. and serves as an index 
of dynamic lung function. It must include, at a 
minimum. Forced 'Vital Capacity and Forced 
Expiratory 'Volume in 1 second. 
"Site" means the facility m which the cardiac 
rehabilitaticMi program is held. 
"Supervising physician" means a physician who is on- 
site during the operation of the cardiac rehabilitation 
program. 

"Symptom-limited heart rate reserve" means the 
difference between the symptom-limited maximal 
heart rate and the resting heart rate. 
"Vocational Questionnaire" means the document used 
for vocational assessment. 
"Vocational Rehabilitation Counselor" means an 



indisidual who provides vocational rehabilitation 
counseling services. 

AuthuntyG.S. 1.^ IE- 1 69. 

SECTION .1200 - CERTIFICATION 

.1201 CERTIFICATION REQUIRED 

(a) Certification of cardiac rehabilitation services as a 
"Cardiac Rehabilitation Program" under the Article occurs upon 
the issuance of a certificate pursuant to the provisions of the 
Article and this Subchapter. Once issued, the certificate 
continues and remains in effect pursuant to the provisions of the 
Article and this Subchapter. 

(b) A certificate issued h\_ tfie Department pursuant to the 
Article and this Subchapter shall be issue d only for ttie premises 
and persont s ) named in the application and shall not be 
transferable m assignable. The named person(s) and the street 
address ot' itie named premises shall appear on the certificate. 

(c) A certificate issued by tjie Department pursuant to the 
Article and this Subchapter shall be pt)sted hi a conspicuous 
place on the premises. 

AitthontxG.S. 131 E- 169. 

.1202 CERTIFICATION PROCESS 

(a) To initiate the certification process, an application for 



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384 



PROPOSED RULES 



certification shall be filed with the Department by the owner of 
the cardiac rchahililalion services. 

(b) Application forms shall be available from the Department, 
and each application shall contain at least the following 
information: 

1 1 ) legal identity of the owner-applicant; 

(2) name or names under which the facility or services 
are advertised or presented to the public; 

(3) program mailing address; 

(4) program exercise site; 

(5) program telephone number; 

(6) ownership disclosure; 

(7) name of program director; 

(8) name ot medical director; and 

(9) program hours of operation. 

(c) No applicant shall offer any cardiac rehabilitation services 
described or represented as a "Certified Cardiac Rehabilitation 
Program." unless the services ha\e been certified in accordance 
with the provisions of' this Subchapter. 

(d) E.xcept as otherwise provided in this Section, the 
Department shall inspect and evaluate the program and premises 
identified in the application and shall thereafter issue a 
certificate uptm Us determination that the applicant has 
substantially complied with, and the program and the services at 
the premises substantially met, the provisions ot.' the Article and 
this Subchapter. 

AuthonnG.S. I3IE-I69. 

.1203 CERTIFICATE RENEWAL 

(a) A certificate issued pursuant to tlie Article and this 
Subchapter shall expire two years after the effective date but can 
be renevsed upon the successful re-evaluation of the program. 
To initiate the renev\al process, an application for certification 
shall be filed with the Department b^. Ih^ owner ot' tfie program. 

(b) Determination of C()mpliance with the prosisions of the 
Article and this Subchapter for purposes of certillcate renewal 
may, at the discretion of the Department, be based upon an 
inspection or upon re\ lew of requested inl't^rmation submitted bv 
a program to the Department. 

(c) The Department, at its discretion, may renew a program's 
certificate based upon evidence pro\ ided hy the program, such 
as an accreditation repc^rt. that it has been inspected, evaluated. 
and approved bv an accrediting body recognized by the 
Department. 

AuthontyG.S. I31E-I67: I3IE-I69. 

.1204 CERTIFICATION FOLLOWING PROGR\M 
CHANGES 

(a) The Department shall be notified, in writing, at least .^0 
da\s prior to the effective date, of any expected occurrences of 
the following: 

( 1 ) change in program ownership: 

(2) change in program name: 

(3) change of Utc premises in which a program is 



Hi 



conducted; and 

the replacement or termination ol. employment oj' the 



" 



program director. 

(h) If a 30-day advanced written notification of an 
occurrence enumerated rn Paragraph (a) ot' this Rule is not 
possible, the Department shall be notified immediately, by any 
reasonably reliable means of notification, (jf such expected or 
completed occurrence, and written notification shall follovs 
immediately thereafter. 

(cl Upon the occurrences enumerated in Subparagraphs 
(a)( 1 ). (2). and |3) oi' this Rule, the owner oi the program shall 
file with the Department an application for certification, w hich. 
at a minimum, shall contain the informaticm specified m Rule 
.1202(b) of tliis Subchapter, and shall provide such other 
documentation and information as rec|uested by the Department. 

(d) The re\ised program shall tie e\aluated for c ompliance 
with the proNJsions of Utc Article and this Section. Esaluation 
may he based upon inspection of tlie program or upon review of 
requested information submitted by a program to the 
Department. After a determination by the Department that the 
program substantially complies with the provisions of the Article 
and this Subchapter, a new certificate shall he issued. 

Authonn- GS. 13JE-J69. 

.1205 INSPECTIONS 

(a) In accordance with G.S. 131E-I67(C). inspection(s) shall 
he made by tlie Department before a program is issued ks initi^ ^ 
certification as a program defined in tjie .Article. ^ 

(b) The Department shall make or cause to fie made such 
other inspections of a program as rt deems necessary in 
accordance with the Article. Circumstances which may be 
deemed to necessitate an inspection include, but are not limited 

liH 

( 1 ) change in program ownership: 

(2) change [n program name: 

(3) change of ihe premises \n which a program is 
conducteth 

(4) the replacement or termination of employment of the 
program director: and 

{5) in\estigation of complaints. 

(c) Inspections may he unannounced and may be conducted 
any time dunng program business hours. The purpose n£ any 
inspection shall he discussed with the Program Director or 
designee during an entrance conference. 

(d) Information deemed necessary by tlie Department to 
evaluate compliance with the .Article and this Suhchaptei. shall 
he made a\ailahle for inspection. The information nia\ include 
medical records, personnel files, pi^licics and procedures, 
program records, interview s w ith program staff. inter\ iews w ith 
patients, obsersation of Utc program in operation, and any other 
information necessary to determine compliance. 

(e) Following completion of an inspection, an exit c< mlerenci^ 
shall be conducted w ith one or more representati\es ni [hM 
program's management. An oral summary of tlie findings shall 
fie presented at the e.xit conference. The Department shal l 



385 



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September L 1999 



14:5 



PROPOSED RULES 



provide the program with a written report of the findings. The 
program shall have JO working days from the receipt ot' the 
. report to respond with a plan of correction which describes the 
Iborrective actions planned and taken to correct any cited 
deficiencyties). the date each deficiency was or will be 
corrected, and the date the program expects to be in compliance 
with the proyjsions of the Article and this Subchapter. 

Autlwiity G.S. 131E-169: 131E-170. 

.1206 ADVERSE ACTION 

(a) Upon a determination that there has been a substantial 
failure to comply with the provisions of the Article or the rules 
contained in this Subchapter, the Department may, at its 
discretion, deny a new or renewal certificate, suspend or revoke 
an existing certificate, or. as enumerated in Paragraph (c) of this 
Rule, issue a provisional certificate. 

(b) Substantial noncompliance which has endangered, or has 
a potential to endanger the health, safety, or welfare of any 
patient, shall be cause fc)r the denial, revocation, or suspension 
of a certificate. 

(c) Substantial noncompliance which does not endanger the 
health, safety, or welfare of the patients being served may, at the 
discretion of the Department, result in the issuance of a 
provisional certificate for a period not to exceed six months. 

Authority G.S. 131E-168: I31E-169. 

|.1207 PROCEDURE FOR APPEAL 

In accordance with G.S. 13 IE- 168(b). all administrative 
action and judicial review in cases where the Department has 
denied a new or renewal certificate, or suspended or revoked an 
existing certificate, shall be governed by the provisions of G.S. 
150B. the Administrative Procedure Act. 

Authoritx G.S. 13IE-]68(b). 



SECTION .1300 - ADMINISTRATION 

.1301 STAFF REQUIREMENTS AND 
RESPONSIBILITIES 

[a] Each program shall be conducted utilizing an 
i nterdisciplinary team. At a minimum, the team shall include 
individuals performing the following functions. The program 
may employ, full-time or part-time, or contract for the services 
of team members. Program staff shall be available to patients as 
needed to perform initial assessments and to implement each 
patient'scardiac rehabilitation care plan. 

(b) Individuals may perform multiple team functions, if 
qualified for each function, as staled in this Rule: 

(1 ) Program Director ^ supervises program staff and 
directs aH facets of die program. The individual 
serving as program director must either be: 

(A) certified by the ACSM as a program director; 
or 

(B) have a bachelor'sdegree in a health or fitness 



♦ 



field and have two years direct clinical 
experience in a health care field. in 
appropriate subject matter. 

(2) Medical Director - physician who provides medical 
assessments and is responsible for supervising all 
clinical aspects of the program and for assuring the 
adequacy of emergency procedures and equipment, 
testing equipment, and personnel. 

(3) Registered Nurse - provides nursing assessments and 
services, and coordinates care in occurrences 
requiring physician intervention or cessation of an 
exercise session. 

(4) Exercise Specialist - provides an exercise assessment. 
in consultation with the medical director, plans and 
evaluates exercise therapies. The exercise specialist 
must either: 

(A) Be certified by the ACSM as an exercise 
specialist or as a program director; or 

(B) Be supervised by a program staff member who 
is certified by the ACSM as an exercise 
specialist or as a program director and: 

([} have a bachelor'sdegree in a health or 
fitness field; 

(ii) have at least one year's experience 
working full-time with adult fitness or 
cardiac rehabilitation programs; 

(iii) be certified in senior lile saving or 
supervised by_ a staff member certified 
in senior life saving if an aquatic 
program is offered. 

(5) Mental Health Professional ; provides directly or 
assists program staff fn completion of the mental 
health screening and referral, if indicated, for further 
mental health services. 

(6) Dietitian or Nutritionist - provides directly or assists 
program staff in completion of tlie nutrition 
assessment and referral, if indicated, for further 
nutrition services. 

(7) Supervising Physician. Physician Assistant, or Nurse 
Practitioner - medicalperson who is on-site during the 
operation of programs that are not located within a 
hospital. 

(8) DVRS or other Vocational Rehabilitation Counselor - 
screens patients who may be eligible for and 
interested fn vocational rehabilitation services, 
develop s assessment and intervention strategies, and 
provides other services as needed to meet the 
vocational goal(s) of patients who may be eligible for 
and interested in services. 

Authority G.S. 131E-169. 

.1302 POLICIES AND PROCEDURES 

The program director shall assure that written policies and 
procedures arc adopted by the prograin. approved by the medical 
director, and available to and implemented by staff. At a 
minimum, these policies and procedures shall include the 



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September 1, 1999 



386 



m^^^ 



PROPOSED RULES 



following areas: 



:i) 



t3j 
ill 



admission of patients and orientation to the program; 

patient assessment, care planning, and implementation 

of therapies; 

patient follow-up evaluations, including progress 

toward cardiac rehabilitation goals; 

patient discharge; 

medical records, in accordance with Rule .2002 of 



this Subchapter; 

(6) orientation ot' al] program personnel; 

(7) maintenance of personnel records which include job 
descriptions, verification of credentials, continuing 
education and current competencies; 

(8) use and orientation of volunteers; 

(9) communication with patient's referral and personal 
physicians; 

(10) provisions for reporting and investigating complaints 
and accidental events regarding patients, visitors and 
personnel (incidents) and corrective action taken; 

(11) emergencN procedures; 

( 12) a preventative maintenance program to assure all 
equipment is maintained i_n safe and proper working 
order and in accordance with the manufacturer's 



(13) 



recommendations; and 
quality improvement program. 



Aiithorirx G.S. I31E-I69. 

.1303 CONTINUOUS QUALITY IMPROVEMENT 

(a) The cardiac rehabilitation program shall have an ongoing 
Continuous Quality Imprcnement ( CQI i program which 
identifies quality deficiencies and addresses them with corrective 
plans of action, as indicated. 

(b) The CQI program shall evaluate the appropriateness, 
effectiveness, and quality oi' the cardiac rehabilitation program, 
with findings used to verify policy implementali(>n. to identify 
problems, and to establish problem resolution and policy 
rev ision as necessary. 

(c) The CQI program shall consist of an overall policy and 
adminislratic^n review, including admission and discharge 
policies, emergency care, patient records, personnel 
qualificationsand program evaluation. Data to he assessed shall 
include, at a minimum, the following; 

( 1 ) number of patients in the program; 

(2) average length (weeks) patients are in the program; 
(?<) patient clinical outcomes; 

(4) adequacy of staff to meet program/patient needs; 

(5) reasons for discharge; and 

(6) untoward events. 

(d) A sample of active and closed records shall he reviewed 
at least quarterly to assure program policies are followed and 
the program is in compliance with the Article and the rules 
contained in this .Subchapter. 

(e) Documentation of the CQI program shall include the 
criteria and methods used to collect and analyze data, 
identification of quality deficiencies, and any aclion(s) taken by 



the cardiac rehabilitation program as a result of C^QI findings 
Aiitlwrir\ G.S. 131E-I69. 

SECTION .1400 - PATIENT RIGHTS 

.1401 PATIENT RIGHTS 

(a) Prior to or at the time of admission, the program shall 
provide each patient with a written notice of the patienl'srights 



I 



and responsibilities. The program shall maintain documentati on 
showing that aH patients have been informed of their rights and 
responsibilities. 

(b) Each patient's rights shall include, at a minimum, the right 
to; 

be infonned and participate in devekiping the patient's 

plan of care; 

voice grievances about the care provided, and not be 

subjected to discrimination or reprisal for doing so; 

confidentiality ol the patienl'srecords; 

be informed of the patienl'sliabilily for payment for 

services; 



Oi 

Ql 

ill 
(4) 



Hi 



(6) 

til 



be informed of the process for acceptance and 
continuation of service and eligibility dcterminatit'n; 
accept or refuse services; and 
be advised of the program's procedures for discharge. 

(c) The program shall prov idc all palicnls with a iclephonc 
number for infomtation. questions or complaints about serv ices 
provided by the program. The program shall also provide th_^ 
Division Complaints Hotlin e number or the Department rJI 
Health and Human Services Careline number. 

(d) The program shall investigate, within seven davs. 
complaints made to the program by the patient, the patient's 
family, and/or significant other, and must document both the 
existence of the complaint and the resolution of the complaint. 

Amhorln G.S. BlE-169. 

SECTION .1500 - ADMISSION AND DISCHARGE 

.1501 ADMISSION AND DISCHARGE 

(a) .All patients admitted to the program shall have a refenal 
from a physician. 

(b) Prior (o discharging a patient, the interdisciplinary team 
shall develop a discharge plan. At a minimum, the discharge 
plan shall include inslruclic^ns as to how to achieve or maintain 
the goals established in the cardiac rehabilitatiim care plan. 

(c) Upon discharge from the program, a discharge summa iA 
as outlined in Rule .2002( a )( 10) of this Subchapter, shall be sent 
to the personal or referring physician. 

AiithorhxG.S. L^lE-169. 



SECTION .1600 - PATIENT ASSESSMENT 



.1601 PATIENT ASSESSMENT 

(a) Within five weeks of a patient's admission to ijie program . 



i 



387 



NORTH CAROLINA REGISTER 



September /. 1999 



14:5 



PROPOSED RULES 



i2j 
14) 



ill 



the interdisciplinan' team shall complete and document a cardiac 

rehabilitation assessment. At a minimum, the assessment shall 

include the components specified in this Rule. 

V ib] Medical Assessment: 

(1 ) cardiovascular evaluation as to present diagnosis, 
therapy, and a discharge summary of the patient's last 
hospitalization; or 

statement by referring physician as to present 
diagnosis, and therapy; 
resting 12-lead ECG; 

medical record documentation prior to or dur i ng the 
first exercise session of ECG. hemodynamic data, and 
the presence or absence of symptoms, preferably 
determined by a graded exercise test. A graded 
exercise test shall not be required when deemed 
unnecessary by the patient's attending or personal 
physician; 

fasting blood chemistry, as indicated, to include total 
cholesterol, hi^ih density lipoprotein (HDL) 
cholesterol, low density lipoprotein (LDL) 
cholesterol, triglycerides, and other comparable 
measures; and 
(6) simple spirometry, if clinically indicated. 

(c) Physical Assessment: 
( 1 ) functional capacity as determined b\ measured or 

predicted equivalents (METs); 

height, weight, and/or other anthr(^pometric measures 

(i.e.. body mass index, percent body fat, waist-lo-hip 

ratio, girth measurements); 

current and past exercise history; and 

physical limitations and disabilities that may impact 

rehabilitation. 

(d) Nursing Assessment: 

Oi 
O) 

recovery from recent cardiac events; 
{?<) presence of comorbidities; 

(4) assessment of medications; and 

(5) educational needs. 

(e) Nutrition .Assessment: 
( 1 ) review of medical history; 

eating patterns as measured by a food diary, food 
frequency questionnaire, or an acceptable alternative; 
fasting blood chemistries as described in 



♦ 



ill 



01 

141 



coronary risk profile; 

current symptoms such as angina or dyspnea, and 



l2i 
lii 
111 



described in 



» 



Subparagraph (b)(5) of this Rule; 

anthropometric measures as _ 

Subparagraph (c)(2) ol this Rule; 

(5) behavioral patterns; 

(6) identification oi nutritional goals. 
Ill Mental Health Assessment: 

( 1) past history of mental illness including depression, 
anxiety, and/or hcistilily or anger; and 

(2) present mental health funclicming and need for 
referral to a mental health professional. 

(g) Vocational Assessment: 
( 1 ) vocational questionnaire to determine current 
vocational status, description of physical requirements 



of job, working conditions, psychological demands as 
perceived by the patient; and 
(2) the need for vocational rehabilitation services. 

AutlwrinG.S. U I El 69. 

SECTION .1700 - CARE PLANNING AND FOLLOW- 
UP EVALUATION 

.1701 CARE PLANNING 

(a) Within five weeks of a patient's admission to the program. 
the interdisciplinary team shall develop a cardiac rehabilitation 
care plan for the patient based upon assessments completed as 
required under Section .1600 oi this Subchapter. 

(b) The cardiac rehabilitation care plan, at a minimum, shall 
include: 

( 1 ) the patient's exercise therapy; 

(2) nutrition services, if indicated; 

(3) mental health services. H' indicated; 

(4) vo cational services if, indicated; 

(5) lucational counseling; 

(6) cardiac rehabilitation goals; and 

(7) discharge planning. 

(c) Within six weeks of the patient's admission to the 
program, a copy of the cardiac rehabilitation care plan shall be 
sent to the patient's personal and referring physicians. 

Aiahorm G.S. lilE-169. 

.1702 FOLLOW-UP EVALUATION 

(a) The interdisciplinary team members shall attend monthly 
meetings for follow-up evaluation of patients' progress toward 
cardiac rehabilitation goals. Changes to each patient's cardiac 
rehabilitation care plan shall be made as needed based on 
cc:)ntinued evaluations. Any changes made in the patient's 
cardiac rehabilitation care plan shall be recorded in the medical 
record and sent to the patient's personal and referring 
phvsician(s). 

(b) If an}^ staff member cannot attend, the reason for the 
absence and the means of communicating information prior to 
and after the meeting shall he documented. 

(c) The personal and referring physician(s) shall be informed 
of any complication or change in patient status while in the 
program. 

(d) Progress notes shall be recorded in the patient's medical 
record evaluating progress toward goals established from the 
plan of care. 

Autlwim G.S. 131 E- 169. 

SECTION .1800 - PROVISION OF SERVICES 

.1801 PERSONNEL 

(a) Al least one ACLS certified and one other staff member 
shall be present at the site during all program hours. 

(b) For cardiac rehabilitation programs that are not located 



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388 



i^^Qj 



PROPOSED RULES 



within a hospital or a hospital emergency resuscitation team is 
not available to respond m an emeriiencv. a supervising 
physician, physician assistant, or nurse practitioner shall he on- 
site during all program hours. 

Aiithoritx G.S. I.^IE-169. 

.1802 EXERCISE THERAPY 

(a) The medical director, in consultation with program staff. 
shall establish staff to patient ratios for exercise therapy sessions 
based on medical acuity, utilizing an acceptable risk 
stratification model. 

(h) If any patient has not had a graded exercise test prior to 
the first exercise session, the patient'sfirst exercise session must 
include objective assessment ot hemodynamic data. ECG. and 
symptom response data. 

(c) Unless contraindicated bv medical and laboratory 
assessments or the cardiac rehabilitation care plan, each patient's 
exercise therapy shall include: 

( 1 ) mode of exercise therapy including, but not limited to: 
walk/jog, aquatic activity, cycle ergometry. arm 
ergometrv. resistance training, stair climbing, rowing, 
aerobics; 

(2) intensity: 

(A) up to 8,S percent of symptom-limited heart rale 
reserve; 

(B) up to 80 percent of measured maximal oxygen 
consumption; 

(C) rating oi' perceived exertion (RPE) of JJ. to 13 
li a graded exercise test is ruH performed; or 

(D) for myocardial infarction patients: heart rate 
not to exceed 20 beats per minute above 
standing resting heart rate if a graded exercise 
test js not performed: and for post coronary 
artery bv-pass ^raft patients: heart rate not to 
exceed 30 beats per minute above standing 
resting heart rate if a graded exercise test is not 
performed; 

duration: uji to 60 minutes, as tolerated, including a 
minimum of five minutes each for warm-up and cool- 
down; 

frequency: minimum of three days per week. 
The patient shall he monitored through the use of 
electrocardiography during each exercise therap y session. The 
frequency ot' the monitoring shall be based on medical acuity 
and risk stratification. 

(e) At two week intervals, the patient's adherence to the 
cardiac rehabililation care plan and progress tcnsard goals shall 
he monit(>red by an examination of exercise therapy records and 
documented. 

(f) The exercise specialist shall be responsible for 
consultation with the medical director or the patient's personal 
physician concerning changes m the exercise therapy, results of 
graded exercise tests, as needed or anticipated (e.g. regular 
follow-up intervals, graded exercise test conducted, or 
medication changes). Feedback concerning changes m the 



i2i 



14] 



exercise therapy shall he discussed with the patient and 
documented. 

(g) Diabetic patients who are taking insulin and/or oni 



I 



hypoglycemic agents for control ol.' diabetes shall have blooc" 
sugars monitored for at least the first week oX cardiac therap\ 
sessions in order to establish the patient's l evel of control and 
subsequent response to exercise. Cardiac rehabilitation staff 
shall record blood sugar measurements pre- and post-exercise. 
Patients whose blood sugar values are considered abnormal shall 
be monitored until better diabetic control is established. Snacks 
shall be available in case oi' a hypoglycemic response. 



Aiithorin G.S. 13 IE- 1 69. 

.1803 NUTRITION SERVICES 

If indicated, based on itie nutrition assessment and cardiac 
rehabilitation care plan, each patient's prt)gram shall include the 
following nutrition services: 

(1 ) interpretation and feedback on tfie patient's eating 
patterns, blood chemistries, anthropometrics, and 
behavioral patterns; 

(2) identification of a therapeutic diet plan to determine. 
at a minimum, a reasonable bod\ weight, caloric, and 
fat intake; 

(3) patient counseling and/or behavioi' modi llcation based 
on the therapeutic diet plan and goals. 



AiithorinG.S. 13 IE- 169. 



I 



.1804 MENTAL HEALTH SERVICES 

It' indicated, based on tlie mental health assessment and 
cardiac rehahilitati(m care plan, each patient's program shall 
include the t'ol lowing mental health ser\ices: 

( 1 ) feedback trom mental health assessment to the 
patient; and 

(2) present mental health functioning and need for 
referral to a mental health professional for evaluation 
or treatment. 

AnrhoriryG.S. 13IE-I69. 

.1805 VOCATIONAL REHABILITATION 
COUNSELING AND SERVICES 

(a) The cardiac rehabilitation program shall have a \\ritten 
agreement, with the local DVRS office or other vocational 
rehabilitationcounselor/services, which specifies the following: 

( 1 ) The program shall administer u Vocational 
Questionnaire to patients. 

(2) After administering the ViK'ationaK)uestionnaire, the 
program shall refer to the DVR.S or I'ther vocational 
rehabilitati(m counselor/services I 'latienis who mav fie 
eligible for and desire services. 

(3) The DVRS or other vocational rehabilitation ^ 
counselor shall provide feedback to ifie caidiacm 
rehabilitation program regarding the eligibility for 
DVRS or other vocational scr\ ices ot referied 



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PROPOSED RULES 



(4] The 



patients. 
The DVRS 



or other vocational rehabilitation 



♦ 



counselor shall provide proiircss reports for patients 
who are receiviniz DVRS or other vocational 
rehabilitation services. 



(5] 



The DVRS or other vocational rehabilitation 
counselor shal l attend monthly staff meetings in 
which eligible vocational rehabilitation clients are 
discussed. If the counselor cannot attend, the reason 
for the absence and the means oi' communicating 
information prior to and after the meetini; shall be 
documented and attached to the stalTmg report. 

(b) The cardiac rehabilitation program must have written 
documentation that feedback as described iji Subparagraph 
(a)(3) of thjs Rule and progress reports as described in 
Subparagraph (a)(4) of this Rule have been communicated to the 
cardiac rehabilitation program by the DVRS or other counselor 
and, if not, the reason(s) why. 

(c) If the program is not able to complete a written agreement 
with the local office of DVRS or other vocational rehabilitation 
counselor as outlined in Paragraph (a) ot' this Rule, the program 
shall have documentation that specifies why such an agreement 
was not completed. 

Aiithorin- G.S. lSlE-169. 

1806 PATIENT EDUCATION 

(a) Each patient'scardiac rehabilitation care plan shall include 
ytrticipation in the program's basic education plan. At a 
minimum, the education plan shall include the following topics: 

( 1 ) basic anatomy, physiology, and pathophysiology of 
the cardiovascular system; 

(2) risk factor reductions, including smoking cessation 
and management oi' blood pressure, lipids, diabetes, 
and obesity; 

(-3) principles of behavior modification including 
nutrition, exercise, stress management and other 
lifestyle changes; 

(4) relaxation training offered at least once per week by 
staff trained in relaxation lechniciues; 

(5) cardiovascular medications including compliance, 
interactions, and side effects; 

(6) basic principles of exercise physiology, guidelines for 
safe and effective exercise therapy, and guidelines for 
vocational/recreational exertional activities; 

(7) recognition of cardiovascular signs, symptoms and 
management; and 

(8) environmental considerations such as exercise in hot 
or cold climates. 

(b) The educational program shall include individual or group 
sessions utilizing written, audio, and/or visual educational 
materials as deemed appropriate and necessary by proizram staff. 

(c) Each session shall fie documented and presented on a 
^Hating basis such that each patient has access to all materials 
and classes offered. 

id] Documentati(tn shall be included in each patient'smedical 
record to indicate which educational programs the patient 



attended. 

Authorin G.S. 13JE-169. 

SECTION .1900 - EMERGENCIES 

.1901 EMERGENCY PLAN 

A written plan approved and signed by the medical director 
shall be established to handle any emergencies oc:urring on site 
while cardiac rehabilitation services are being provided. All 
areas oi" the pre mises pertinent to program operation shall be 
included. The plan shall address the assignment of personnel 



and availability oi equipmeni required in an emergency. 
Authoritx G.S. IJlE-169. 

.1902 EMERGENCY EQUIPMENT 

The following equipment and supplies must be available and 
operable in the event of an emergency and must fie maintained 
according to manufacturer' srecommendations; 
(1) suction equipment (portab ' • y, 
defibrillator (portable); 
intubation equipment; 
medications; 
oxygen tank supply; 



(21 
ill 

141 
ill 
161 

121 



regulator and mask for nasal cannula; and 
communication system to access emergency medical 

ser\'ices. 



Authoritx G.S. 131E-169. 

.1903 EMERGENCY DRILLS 

(a) At least six patient emergency drills shall be conducted 
each year and shall be documented. 

(b) Drill sites shall he rotated through aH k)cations used by 
patients while participating in program activities. 

(c) The drill documentation and effectiveness of emergency 
drills shall f>c reviewed and signed by the medical director or 
supervisint; physician. 

Authoritx G.S. J. ^ IE- 1 69. 

SECTION .2000 - MEDICAL RECORDS 

.2001 POLICIES AND PROCEDURES 

The program shall develop and implement policies and 
procedures to include at least the folK)wing: 

( 1 ) maintenance of a complete, accurate, and organized 
medical record for each patient admitted to the 
program; 

confideiuiality oi records; 

accessibility of medical record information to the 
patient, program staff, and non-employees; 
authentication oi' entries in medical records including 
hard copy records and those kept in electronic 
medium such as computerized records; and 



121 
111 

111 



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390 



wm 



PROPOSED RULES 



(3) retention and disposition of records in accordance 
with the NC Statutes oi Limitations. G.S. 1-15. 1-17. 

Aiithorin G.S. I.^IE-169. 

.2002 CONTENT OF MEDICAL RECORDS 

(a) The medical record shall contain at least the following 
information: 



H] 
16] 

m 

IHJ 

(9) 

0) 



patient identification data; 

medical history and, uhen applicable, hospital 

discharge summary; 

graded exercise data, if available; 

resting 12-lead ECG; 

signed physician referral; 

records of blood chemistry analyses; 

signed informed consent lo participate in the program; 

progress notes and response to the cardiac 

rehabilitation care plan; 

al] records of each discipline's participation in the 

patient'scardiac rehabilitation care plan; 

a discharge summary which describes the patient's 

progress while in the program, reason(s) for 

discharge, the post-discharge plan, and follow-up as 

indicated; 



(11) 



miscellaneous clinical records developed pursuant to 
the palient'scourse of treatment, 
(b) In the case of hard copy medical records, the following 
shall apply; 

( 1 ) the patient's name must he recorded on each page of 
the record; 

(2) all entries in the records shall be legible and 
authenticated with a signature, title, and date by the 
individual making the entry; and 

(3) faxed entries, including orders, are acceptable as long 
as a hard copy is incorporated in the medical record 
(note: thermal paper faxes are not acceptable). 

£cj At Us option, the program may maintain all or part of its 
medical records in a form other than hard copy, such as 
electronic medium. Entries in such a record shall he 
authenticated according to program policies and may include 
authentication measures such as pers(inal computer entry codes 
or electronic signatures. However, when requested by the 
Division or other State officials, the program must be able to 
produce a hard copy printout of the record. 

(d) Medical record information may be stored, such as when 
records are thinned or patients are discharged, in a form other 
than hard copy, but the program must be able to produce a hard 
copy printout of the record d ' reuuested hi the Division or other 
State officials. 

AialH)rit\ G.S. IJIE-I69. 

SECTION .2100 - FACILITIES AND EQUIPMENT 

.2101 PHYSICAL ENVIRONMENT AND 
EQUIPMENT 



(a) The program shall provide a clean and sale environnieiil. 



(b) Equipment and furnishings shall be cleaned not less than 
weekly. 

(c) All areas of the facility shall be orderly and free of debrJl 



and with clear traffic areas. 



(d) A written and documented preventative maintenanc e 
program shall be established to ensure that aH equipment js 
calibrated and maintained hi sale and proper working order in 
accordance with manufacturers' recommendations. 

(e) There shall be emergency access to all areas a patient mav 
enter, and floor space must allow easy access of personnel and 



equipment. 

(f) Exit signs and an eyacuation plan shall be posted and 
clearly visible. The evacuation plan shall detail evacuaiion 
routes for patients, staff, and visitors in case of fire or other 
emergency. 

(g) No smoking shall be permitted in patient care or treatment 
areas. 

AiirlwrirxG.S. 1 31 E- 169. 

.2102 GRADED EXERCISE TESTING LABORATORY 

If the program performs graded exercise testing, the folhnv ing 
facilities and equipment shall be available: 

( 1 ) space for physical examination which allows for 
visual privacy; 

(2) adequate space and temperature and humidity controls 
for exercise as described under "Phvsicc 



u 



Environment and Equipment" of' this Subchapter; 
{?<) 12-lead ECG equipment for recording the ECG 
during exercise testing; 

(4) oscilloscope for ECG monitoring or continuous 
recording; 

(5) treadmill, bicycle ergometer. or arm crank ergomeier; 

(6) blood pressure cuff and sielhoscope; 

(7) emergency procedures, equipment, and supplies as 
described in "Emergencies" of this Subcliapter; and 

(8) access to spirometer for pulmonary function testing. 

Authorin G.S. BIE- 1 69. 

.2103 EXERCISE THERAPY 

The following equipment shall be available and operable for 
the provision ot' exercise assessment and therapy : 

( 1 ) ECG and oscilloscope; 

(2) hk^md pressure cuff and stethoscope; 

(3) large clock yy ith sweep second hand; 

(4) blood glucose testing equipment; and 

(5) equipment lor the performance of anthropometric 
measurements such as skinfold caliper, stadiomeler. 
tape measure, and physician'sscale. 



Antlwrirx G.S. 13 IE- 169. 



i 



.2104 NUTRITION SERVICES 

If provided on site, the fcilUnving facilities and equipmen i 



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September I, 1999 



14:5 



PROPOSED RULES 



shall be available for the provision of nutrition services: 

( 1) space that allows for confidential interviewing and 

k counseling; 

^ (2] nutrition guidelines and means of nutrient analysis: 
and 

educational materials, as deemed appropriate by the 
program'sdietitian/nutritionist. forpatient distribution 
and use during nutrition therapy counseling. 



ill 



Authority G.S. 131E-169. 

.2105 MENTAL HEALTH SERVICES 

If provided on site, space shall be available for the provision 
of the mental health services to allow for confidential 
interviewing and counseling. 

Authority G.S. 131E-169. 

.2106 VOCATIONAL REHABILITATION SERVICES 

If provided on site, space shall be available for the provision 
of vocational rehabilitation services to allow for confidential 
interviewing and counseling. 



(2) The amendments also specify that coun review of decisions 
may be sought by bringing a civil action in any State Court of 
competent jurisdiction or any district court of the United States 
of competent jurisdiction. The previous federal law did not 
address court review. 

Comment Procedures: Comments may be presented orally or 
in writing at the hearing. Oral statements may be limited at the 
discretion of the hearing officer. Written comments may be 
submitted until October I, 1999 to Jackie Stalnaker, Division of 
Vocational Rehabilitation Senices. 2801 Mail Service Center, 
Raleigh, NC 27699-2801. To obtain additional information or 
indicate need for alternative communication format contact Ms. 
Stalnaker in writing or by phone (919) 733-3364 or (919) 733- 
5924 (TDD). In addition a fiscal note is available upon written 
request from the same address. 



Fiscal Impact 
State Local 



Sub. 



None 
/ 



CHAPTER 20 - VOCATIONAL REHABILITATION 



Authorities. 131E-169. 



SUBCHAPTER 20B - PROCEDURE 



Wf^TOtke is hereby given in accordance with G.S. 150B-21 .2 
x\ that the DHHS - Division of Vocational Rehabilitation 
Services intends to amend the rules cited as 10 NCAC 20B 
. 0224, .0228. Notice of Rule-making Proceedings was published 
ill the Register on March 1. 1999. 

Proposed Effective Date: July 1, 2000 

A Public Hearing will be conducted at 2:00 p.m. on September 
21, 1999 at the Division of Vocational Rehabilitation Senices, 
Main Conference Room. 805 Ruggles Drive. Dorothea Dix 
Campus, Raleigh. NC. 

Reason for Proposed Action: On August 7, 1998 the Federal 
Workforce Investment Act of 1998 (P.L. 105-220) was enacted. 
Included in this Act were the 1998 Amendments to the 
Rehabilitation Act. Section 102(c) of the Rehabilitation Act 
Amendments made several changes to the requirements for 
Stales to establish procedures for impartial due process 
hearings as follows: 

( 1 ) The amendments require that the procedures enable a paiT\- 
in an appeal to seek a review of a hearing officer's decision by 
the head of the designated State Agency (the Department of 
Health and Human Senices) or an official of the Governor's 
Office. Previous federal law pennitted a review of the hearing 
mfficer's decision by the Division Director upon his own 
discretion. The Federal agency has indicated there will be a 30 
day deadline for the review. 



SECTION .0200 - CONTESTED CASES: 
ADMINISTRATIVE REVIEWS: APPEALS HEARINGS 

.0224 SECRETARY'S REVIEW AND FINAL 
DECISION 

(a) The d i v i sio n directo r Either party may request an 
impartial review of the hearing officer's decision and render the 
final decision, by the Secretary of the Department of Health and 
Human Services within 20 days of the receipt of the decision. 

(b) The Secretary may delegate the responsibility for 
r eviewing the hearing officer's decision and making the final 
decision to another employee ol' the Department but shall not 
delegate the responsibility to an^ officer or einployee of the 
Division. 

(c) If the divis i on di r ector decides to review the hearing 
office r 's dec i sion, In conducting the review, the direc t or 
reviewing official shall send the written notification to both 
parties and allow the submission of additional evidence as 
required by Sec. 102 [c] of the Rehabilitation Act ot' 1973 (as 
amended by the Rehabilitation Act Amendments of 1998. f*4 
C.F.R. .^ 6 1.4S(c)(2)( i vl and(vii). PL. 105-220). The vvritten 
notification shall be gi\ en to the applicant orclient personally or 
by certified mail. If given by certified mail, it shall be deemed 
to have been given on the delivery date appearing on the return 
receipt. 

(trXd) The division director's decision to r ev ie w tlie hea rin g 
officer's decision reviewing official's review shall be based on 
the following standards of review- 
ID Is the hearing officer's decision arbitrary, capricious, 
an abuse of discretion, or otherwise unreasonable'? 



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September I, 1999 



392 



■■IBBSg??^ 



PROPOSED RULES 



(2) Is the hearing officers decision supported by 

substantial evidence, i.e., consistent with facts and 

applicable federal and state policy? 
{?•) In reaching the decision, has the hearing officer given 

appropriate and adequate interpretatitm to such factors 

as: 

( A ) the federal statute and regulations as they apply 
to specific issue(s) in question; 

(B) the state plan as it applies to the specific 
issue{s) in question; 

(C) division rules as they apply to the specific 
issue{s) in question; 

(D) key portions of conflicting testimony; 

(E) division options in the delivery of services 
where such options are permissible under the 
federal statute; and 

(F) restrictions in the federal statute with regard to 
such supportive services as maintenance and 
transportation. 

fd) [ej Upon a detciiriinatio n to r e v iew the hearing officer's 
dec i sion. The di\ ' isio n director reviewing official shall make the 
final decision and provide such decision in writing to both 
parties within .^0 days of pr ov i ding n otice of int en t to r evi e w, the 
date the request for a review of the hearing officer .s decision 
was received. The decision shall include a full report of the 
findings and the grounds lor the decision, the w ri tte n re p o r t 
thereof as required liy 34 C.F.R. ,16 1 .48(c )(2)( v i ii ) and (ix). The 
di vis i on d ir ecto r re\'iewing official shall not overturn or modify 
a decision, or part of a decision, of an impartial hearing officer 
that supports the position of the individual except as allowed 



I 



under Sec. 102(c) of theRehabilitation Act of 197,1 (as amended 
by the Rehabilitation Act Amendments oi 199?S. P.L. -Ht2--5fi¥ 
105-220). Sec ti on l02(d)(,l>(C). The final decision shall bi 
given to the both ap p licant parties or climt personally or b^ 
certified mail. If given by certified mail, it shall be deemed to 
have been given on the delivery date appearing on the return 
receipt. 

(f)te) The hearing officer's decision shall be the final decision 
under the conditions specified in 3 4C.r. RTT^ h4 8(c)(2)( Tt: Sec. 
102(c) of the Rehabilitation Act of 197,1 (as amended by the 
Rehabilitation Act Amendments of 1998, P.L. 105-220). 

(g)ffi The division director shall forward a copy of the final 
decision, whether issued under fdl [eJ or fd (f) of this Rule, to 
the depu t y director Chief of Operations, the CAP director, the 
regional director, and the applicant's or client's representative, 
as appropriate. A copy shall also be included in the individual's 
official case record. 

Aialwriu G.S. 143-545.1: 143-546. 1: 15()B-1: P.L 105-220. 

.0228 CIVIL ACTION 

Judicial review of decisions issued pursuant to Rules .0202 
through .0225 of this Section shall be as spccifieil in G.S. 150B. 
A r licle4 with th e e x c epti o n of G.S. 150D 51 ( a) wh i ch shall not 
apply. Sec. 102(c) of the Rehahililation Act of ]973 (as 
amended by the Rehabilitation Act Anicndnients oi 1998, P.L. 
105-220). 

Authorin G.S. 143-545.1: 143-546.1: I50B-I: P.L. 105-220. % 



< 



393 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



TEMPORARY RULES 



The Codifier of Rules has entered the following temporary rule(s) in the North Carolina Administrative Code. Pursuant to G.S. 
150B-21. 1(e). publication of a temporary rule in the North Carolina Regi.ster sen'es as a notice of rule-making proceedings 
unless this notice has been previously published by the agency. 



TITLE 10 - DEPARTMENT OF HEALTH AND 
HUMAN SERVICES 

Rule-making Agency: DHHS-Division of Medical Assistance 

Rule Citation: 10 NCAC 26H .0304 



Effective Date: September 8. 1999 

Findings Reviewed by: Beecher R. Gray 

Authority for the rule-making: G.S. 108A-25(b}: 108A-54; 
W8A-55: 42 C.F.R. Part 447. Subpart C 



Reason for Proposed Action: The application of the upper 
payment limit is an aniuuil test peiformed by the Division of 
Medical Assistance to assure that the program is in compliance 
with the applicable federal regulations. The review this year of 
the cost report information for the fiscal period ending June 3U. 
1998, adjusted forward for inflation, would be expected to have 
a total of payments that would exceed the total of cost. 

VComment Procedures: Written comments concerning this rule- 
making action must be submitted to Portia W. Rochelle. Rule- 
making Coordinator. Division of Medical Assistance. 1985 
V instead Drive. 2504 MailSerx'ice Center, Raleigh. NC 27699- 
2504. 

CHAPTER 26 - MEDICAL ASSISTANCE 

SUBCHAPTER 26H - REIMBURSEMENT PLANS 

SECTION .0300 - ICF-MR PROSPECTIVE RATE PLAN 

.0304 RATE SETTING METHOD FOR NON-STATE 
FACILITIES 

(a) A prospective rate shall be determined annually for each 
non-state facility to be effective for dates of service for a 1 2 
month rate period beginning each July 1. The prospective rate 
shall be paid to the provider for every Medicaid eligible day 
during the applicable rate year. The prospective rate may be 
determined after the effective date and paid retroactively to that 
date. The prospective rate may be changed due to a rate appeal 
under Rule .0308 of this State Plan or facility reclassification 
under Paragraph (b) of this Rule. Each non-state facility, except 
those facilities where Paragraph (v) of this Rule applies, shall be 
classified into one of the following groups: 
m (1) Group 1- Facilities with .32 beds or less. 

(2) Group 2- Facilities with more than .32 beds. 

(3) Group3-Facilities with medically fragile clients. For 



rate reimbursement purposes under this Rule 
medically fragile clients are defined as any individual 
with complex medical problems who have chronic 
debilitating diseases or conditions of one or more 
physiological or organ systems which generally make 
them dependent upon 24-hour a day 
medical/nursing/health supervision or intervention. 
(4) Facilities in group 1 or 2 in Subparagraph (a)( 1 ) or (2) 
of this Rule shall be further classified in accordance 
to the level of disability of the facility's clients, as 
measured by the Developmental Disabilities Profile 
(DDP) assessment instrument which along with the 
scoring instrument are hereby incorporated by 
reference, including subsequent amendments and 
editions. This material is available for inspection and 
copies may be obtained from the Division ot Medical 
Assistance, 1983 Umstead Drive. Raleigh, North 
Carolina 27603 at a cost of twenty cents ($.20) per 
page. A summary of the levels of disability is shown 
in the following chart: 

FACILITY DDP SCORE 



Low 



High 



200.00 


300.00 


125.00 


199.99 


100.00 


124.99 


75.00 


99.99 


50.00 


74.99 



Level 

1 
2 
3 
4 
5 



(b) Facilities shall be reclassified into appropriate groups as 
defined in Paragraph (a) of this Rule. 

(1) When a facility is reclassified, the rate shall be 
adjusted retroactively back to the date of the event 
that caused the reclassification. This adjustment shall 
give full consideration to any reclassification based on 
the change in facts or circumstances during the year. 
Overpayments related to this retroactive rate 
adjustment shall be repaid to the Medicaid program. 
Underpayments related to this retroactive rate 
adjustment shall be paid to the provider. 

(2) TTie provider shall be given the opportunity to appeal 
the merits of the reclassification of any facility, prior 
to any decision by the Division of Medical 
Assistance. 

(3) The provider shall be notified in writing 30 days 
before the implementation of new rates resulting from 
the reclassification of any facility. 

(4) The providers and the Division of Medical Assistance 
shall make every reasonable effort to ensure that each 



14:5 



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394 



TEMPORARY RULES 



facility is properly classified for rate setting purposes. 

(5) A provider shall file any request for facility 
reclassification in writing with the Division of 
Medical Assistance no later than 60 days subsequent 
to the proposed reclassification effective date. 

(6) For facilities certified prior to July 1. 199.^. the 
facility DDP score calculated for fiscal year 199.^ 
shall be used to establish proper classification at July 
1, 1995. 

(7) For facilities certified after June 30, 1993. the most 
recent facility DDP score shall be used to establish 
proper classification. 

(8) A facility reclassification review shall use the most 
current facility DDP score. 

(9) A facility's DDP score shall be subject to independent 
validation by the Division of Medical Assistance. 

(10) A new facility that has not had a DDP survey 
conducted on its clients shall be categorized as a level 
2 facility for rate setting purposes, pending 
completion of the DDP survey. Upon completion of 
the DDP survey, the facility shall be subject to 
reclassification and rates shall be adjusted 
retroactively back to the date of certification. 
Overpayments related to this retroactive adjustment 
shall be paid to the Medicaid program. 
Underpayments related to this retroactive rate 
adjustment shall be paid to the provider, 
(c) Facility rates under this Rule shall be established at July 
. 1995, under the following: 

( 1 ) For facilities certified prior to July 1 . 1 993. rates shall 
be derived from the 1993 cost reports. 

(2) For facilities certified during fiscal year 1993-1994, 
the fiscal year 1994 facility specific cost report shall 
be used to derive rates. 

(3) For facilities certified during fiscal year 1994-1995, 
the fiscal year 1995 facility specific cost report shall 
be used to derive rates. 

(A) Rates for these facilities shall not be adjusted, 
except for the impact of inflation under 
Paragraph (k) of this Rule, until the fiscal year 
1995 cost report has been properly reviewed. 
Rates for these facilities shall be adjusted 
retroactively back to July 1, 1995, once the 
fiscal year 1 995 facility specific cost report has 
been properly reviewed. Overpayments related 
to this retroactive rate adjustment shall be 
repaid to the Medicaid program. 
Underpayments related to this retroactive rate 
adjustment shall be paid to the provider. 

(4) Facilities with rates established during a rate appeal 
proceeding with the Division of Medical Assistance 
during fiscal years 1994 or 1995 shall not have their 
rates established in accordance with Subparagraph 
(c)( I ), (c)(2), or (c)(3) of this Rule. 

(A) The rates for these facilities shall remain at the 
level approved in the rale appeal proceeding 



adjusted only for infiation. as refiectcd in 
Paragraph (k) of this Rule. 

(d) For facilities certified after June 30, 1993, rates developed 
from filed cost reports for fiscal years subsequent to 1993 ma 
be retroactively adjusted if there is fountl to exist more than a 
two percent difference between the filed per diem cost and either 
the desk audited or field audited per diem cost for the same 
reporting period. Rates developed from desk audited cost 
reports may be retroactively adjusted if there is found to e.\isi 
more than a two percent difference between the desk audited per 
diem cost and the field audited per diem cost for the same 
reporting period. The rate adjustment may be made after written 
notification to the provider 30 days prior to implementation of 
the rate adjustment. 

(e) Each prospective rate developed in accordance with 
Subparagraph (c)( 1 ), (c)(2), or(c)(3) of this Rule consists of the 
sum of two components as follows: 

( 1 ) Indirect care rate. 

(2) Direct care rate. 

(f) A uniform industry wide indirect care rate shall be 
establishedforeachfacilitycategory shown under Subparagraph 
(a)(l ), (a)(2), or (a)(3) of this Rule. 

(1 ) The indirect rate for group 1 facilities is based on the 
fiftieth percentile of the following costs incurred by 
all group I facilities v\ith six beds or less, except 
those related by common ov\nership or control to 
more than 40 said facilities: 

(.^) The sum of the cost of property ownership and 
use, administrative and general, and operalio' 
and maintenance of plant, as determined by the 
Myers and Stauffer study performed on the 
1993 base year cost reports. 

(2) The indirect rate for group 2 facilities is based on the 
fiftieth percentile of the costs noted in Part (f)( \hA) 
of this Rule incurred by the group 2 facilities, as 
determined by the Myers and Stauffer study 
performed on the 1993 base year cost reports. 

(3) The indirect rate for group 3 facilities is based on the 
fiftieth percentile of the costs noted in Part (f)(l )(A) 
o\' this Rule incurred by the group 3 facilities, as 
determined by the Myers and Stauffer study 
performed on the 1993 base year cost reports. 

(4) The indirect rates established under Subparagraphs 
(f)( 1 ), (f)(2), and (f)(3) of this Rule shall be reduced 
as determined based on industry cost analysis by an 
amount not to exceed four percent to account fur 
expected operating efficiencies. 

(g) Thedirect care rate for facilities certified prior to July I. 
1 993. shall be based on the Myers and Stauffer study performed 
on the 1993 base year cost reports. 

( I ) The direct care rate for all facilities certified during 
fiscal years subsequent to fi.scal year 1993 is based on 
the first facility specific cost report filed aftec 
certification. Based on said cosi report, the direct can 
rate is equal to the sum of all allowable costs refiected 
in the ICF-MR cost report cost centers, as included in 



1^ 



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the ICF-MR cost report format effective July 1, 1993, 
except for the following indirect cost centers: 

. (A) Property Ownership and Use 

■ (B) Operation and Maintenance of Plant and 

Housekeeping-Non-Labor 
(C) Administrative and General 

(2) The direct care rate shall be limited to the lesser of the 
actual amount incurred in the base year or the cost 
limit deri- ed from the fiftieth percentile of direct care 
costs incurred by the related facility group in the 
fiscal year 1 993 base year, based on the Myers and 
Stauffer study. 

(3) The fiftieth percentile cost limit shall be reduced by 
one percent each year, for the four year period 
beginning July 1. 1996. in order to account for 
expected operating efficiencies, as determined based 
on industry cost analysis. 

(4) The fiftieth percentile cost limit shall be increased 
each year by price level changes calculated in 
accordance with Paragraph (k) of this Rule. 

(h) "^ -J indirect rate shall not be subject to cost settlement. 

( 1 ) Costs above the indirect rate shall not be paid to the 
provider. 

(2) Costs savings below the indirect rate shall not be 
recouped from the provider. 

(i) The direct care rate shall be subject to cost settlement, 
based on the cost report, subject to audit. Illed with the Division 
of Medical Assistance. 

( 1 ) Costs above the direct rate shall not be paid to the 
provider. 

(2) Cost savings below the direct rate shall be recouped 
from the provider. 

(J) Facilities with rates established during a rate appeal 
proceeding with the Division of Medical Assistance during 
fiscal years 1994 or 1995 may choose to cost settle under the 
provisions of Paragraphs (h) and (i) of this Rule, or under the 
following procedure: 

( 1 ) If. during a cost reporting period, total allowable costs 
are less than total prospective payments, then a 
provider may retain one-half of said difference, up to 
an amount of five dollars ($5.00) per patient day. The 
balance of unexpended payments shall he refunded to 
the Division of Medical Assistance. Costs in excess 
of a facility's total prospective payment rate are not 
reimbursable, 

(2) The facilities subject to the Paragraph shall make the 
election on cost settlement methodology on or before 
the filing of the annual cost report with the Division 
of Medical Assistance. 

(3) .An election to follow the cost settlement procedures 
of Paragraphs (h) and (i) of this Rule shall be 
irrevocable. 

(4) Rates established for these facilities during future rate 
k appeal proceedings shall be subject to the cost 
" settlement procedures of Paragraphs (h) and (i) of this 

Rule. 
(k) To compute each facility's current prospective rate, the 



♦ 



direct and indirect rates established by Paragraphs (f) and (g) of 
this Rule shall be adjusted for price level changes since the base 
year. No inflation factor for any provider shall exceed the 
maximum amount permitted for that provider by federal or state 
law and regulations. 

( 1 ) Price level adjustment factors are computed using 
aggregate costs in the following manners: 

(A) Costs shall be separated into three groups: 

( i ) Labor, 
(ii) Non-labor, 
(iii) Fixed. 

(B) The relative weight of each cost group is 
calculated to the second decimal point by 
dividing the total costs of each group (labor, 
nonlabor. and fixed) by the total cost of the 
three categories. 

(C) Price level adjustment factors for each cost 
group shall be established as fiillows: 

(i) Labor. The percentage change for labor 
costs is based on the projected average 
hourly wage of North Carolina service 
workers. Salaries for all personnel shall 
be limited to levels of comparable 
positions in state owned facilities or 
levels specified by the Division of 
Medical Assistance. 

(ii) Nonlabor. The percentage change for 
nonlabor costs is based on the projected 
annual change in the implicit price 
deflator for the Gross National Product 
as provided by the North Carolina 
Office of Slate Budget and 
Management. 

(iii) Fixed. No price level adjustment shall 
be made for this category. 

(D) The weights computed in Part (k)( 1 )(B) ofthis 
Rule shall be multiplied by the rates computed 
in Part (k)( 1 )(C) of this Rule. These weighted 
rates shall be added to obtain the composite 
inflation rale lo be applied to both the direct 
and indirect rates. 

(2) II necessary, the Division of Medical .Assistance shall 
adjust the annual inflalion factor iji order to prevent 
payment rates from exceeding upper payment limits 
established by Federal RcL!ulalions. 

(I) Effective July 1. 1995. any rale reductions resulting from 
this Stale Plan shall be implemented based on the following 
deferral methodology: 

( 1 ) Rales shall be reduced for the excess of current rates 
over base year costs plus inflalion. 

(2) Rales shall be reduced a maximum of 50 percent oi 
the fiscal 1996 inflation rale for the excess of actual 
costs over applicable cost limits. This reduction shall 
result in the facility receiving at a minimum 50 
percent of the 1996 inflation rate. Any excess 
reduction shall be carried forward lo future years. 

(3) Total reduction in tulurc years related lo the excess 



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396 



TEMPORARY RULES 



reduction carried forward from Subparagraph (I )( 2) of 
this Rule, shall not exceed the annual rale of inflation. 
This reduction shall result in the facility receiving at 
a minimum the rale established in Paragraph (1)(2) of 
this Rule. Any excess reduction shall be carried 
forward lo future years, until the established rate 
equals that generated by Paragraphs ( f), (g), and (k) of 
this Rule. 
(4) Rates calculated based on Subparagraphs (1)(2) and 
(3) of this Rule shall be cost settled based on the 
provisions of Subparagraph (j)( 1 ) of this Rule until 
the fiscal year that the facility receives full price level 
increase under Paragraph (k) of this Rule. 

(A) A provider may make an irrevocable election 
to cost settle under the provisions of 
Paragraphs (h) and (i) of this Rule during the 
deferral period. 

(B) Once the rates calculated based on 
Subparagraphs {1)( 2) and (3) of this Rule reach 
the fiscal year that the facility receives the full 
price level increase under Paragraph (k) of this 
Rule, then said fiscal years rates shall be cost 
settled based on Paragraphs (h) and (i) of this 
Rule. 

(C) Chain providers are allowed to file combined 
cost reports, for cost settlement purposes, for 
facilities that use the same cost settlement 
methodolog) and have the same uniform rate. 

(D) A provider may request from the Division of 
Medical Assistance permission to continue cost 
settlement under Subparagraph (j)(l ) of this 
Rule after the deferral period expires. Said 
request shall be made each year, 30 days prior 
to the cost report due date. 

(m) The initial rate for facilities that have been awarded a 
Certificate of Need is established at the lower of the fair and 
reasonable costs in the provider's budget, as determined by the 
Division of Medical Assistance, or the projected costs in the 
provider's Certificate of Need application, adjusted from the 
projected opening date in the Certificate of Need application to 
the current rate period in which the facility is certified based on 
the price level change methodology set forth in Paragraph (k) of 
this Rule, or the rate currently paid to the owning provider, if the 
provider currently has an approved chain rate for facilities in the 
related facility category. The rate may be rebased to the actual 
cost incurred in the first full year of normal operations in the 
year an audit of the first year of nomial operation is completed. 

( 1 ) In the event of a change in ownership, the new owner 
receives no more than the rate of payment assigned to 
the previous owner. 

(2 ) Except in cases wherein the provider has failed to file 
supporting information as requested by the Division 
of Medical Assistance, initial rates shall be granted to 
new enrolled facilities no later than 60 days from the 
provider's filing of properly prepared budgets and 
supporting iniormation. 



(3) 



(4) 



(2) 



(3) 



The initial rate for a new facility shall be applicable to 
all dates of service commencing with the date the 
facility is certified by the Medicaid Program. a 

The initial rate for a new facility shall not be entered' 
into the Medicaid payment system until the facility is 
properly enrolled in the Medicaid program and a 
Medicaid identification number has been assigned to 
the facility by the Division of Medical Assistance, 
(n) A provider with more than one facility may be allowed to 
recover costs through a combined uniform rate for all facilities. 
( 1 ) Combined uniform rates for chain providers shall be 
approved upon written request from the provider and 
after review by the Division of Medical Assistance. 
In determining a combined uniform rate for a 
particular facility group, the weighted average of each 
facility's rate, calculated in accordance to all other 
provisions of this Rule, shall be used. 
A chain provider with facility(s) that fall under 
Paragraphs (h) and (i) of this Rule and with facility(s) 
that fall under Subparagraph (1)(4) of this Rule may 
elect to include the facilities in a combined cost report 
and elect to cost settle under either Paragraphs (h) and 
(i) or Subparagraph (1)(4) of this Rule. The cosi 
settlement election shall be made each year. 30 days 
prior to the cost report due dale, 
(o) Each out-of-state provider shall be reimbursed at the 
lower of the applicable North Carolina rate, as established by 
this plan for in-state facilities, or the pro\ ider's per diem rate as^ 
established by the stale in which the pro\ idcr is located. An oul-B 
of-state provider is defined as a provider that is enrolled in the 
Medicaid program of another state and provides ICF-MR 
services to a North Carolina Medicaid client in a facility located 
in the slate of enrollment. Rates for out-of-state providers are 
not subjeci to cost settlement. 

(p) Under no circumstances shall the Medicaid per diem rale 
exceed the private pay rale of a facility. 

(q) Should the Division of Medical Assistance he unable to 
establish a rale for a facility, based on this Rule and the 
applicable facts known, the Division of Medical Assistance may 
approve an interim rate. 

(1) The interim rate shall not exceed the rale cap 
established under this Rule for the applicable facility 
group. 

(2) The interim rate shall be replaced by a permanent rate, 
effective retroactive to the commencement of the 
interim rale, by the Division of Medical Assistance, 
upon the determination of said rale based on this Rule 
and the applicable facts. 

(3) The provider shall repay lo the Di\ ision of Medical 
Assistance any overpayment resulting from the 
interim rate exceeding the subsct|uenl permanenl rale. 

(r) In addition lo the prospective per i.iicm rate developed 
under this Rule, effeclive luly 1 . 1992. an interim paymcnl add 
on shall be applied to the total rale lo cover the estimated coslB 
required under Title 29. Part 1910. Subpart 2. Rule 191().10.'^0 ' 
of the Ci)de of Federal Regulations. The inleiim rale shall be 



397 



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14:5 



TEMPORARY RULES 



I 



» 



I 



subject to tlnal settlement reconciliation with reasonable cost to 
meet the requirements of Rule 1910.1030. The final settlement 
reconciliation shall he effectuated during the annual cost report 
settlement process. An interim rate add on to the prospective 
rate shall be allowed, subject to final settlement reconciliation, 
in subsequent rate periods until cost history is available to 
include the cost of meeting the requirements of Rule 1910.1 030 
in the prospective rate. This interim add on shall be removed, 
upon 10 days written notice to providers, should it be 
determined by appropriate authorities that the requirements 
under Title 29 Part 1910, Subpart 2, Rule 1910.1030 of the 
Code of Federal Regulations do not apply to ICF-MR facilities. 

(s) All rates, except those noted otherwise in this Rule, 
approved under this Rule are considered to be permanent. 

(t) In the event that the rate for a facility cannot be developed 
so that it shall be effective on the first day of the rate period, due 
to the provider not submitting the required reports by the due 
date, the average rate for facilities in the same facility group, or 
the facility's current rate, whichever is lower, shall be in effect 
until such time as the Division of Medical Assistance can 
develop a new rate. 

(u) When the Division of Medical Assistance develops a new 
rate for a facility for which a rate was paid in accordance with 
Paragraph (t) of this Rule, the rate developed shall be effective 
on the first day of the second month following the receipt by the 
Division of Medical Assistance of the required reports. The 
Division of Medical Assistance may, upon its own motion or 
upon application and Just cause shown by the provider, within 
60 days subsequent to submission of the delinquent report, make 
the rate retroactive to the beginning of the rate period in 
question. Any overpayment to the provider resulting from this 
temporary rate being greater than the final approved prospective 
rate for the facility shall be repaid to the Medicaid Program. 

(v) ICF-MR facilities meeting the requirements of the North 
Carohna Division of Facility Services as a facility affiliated with 
one or more of the four medical schools in the state and 
providing services on a statewide basis to children with various 
developmental disabilities who are in need of long-term high 
acuity nursing care, dependent upon high technology machines 
(i.e. ventilators and other supportive breathing apparatus) 
monitors, and feeding techniques shall have a prospective 
payment rate that approximates cost of care. The payment rate 
may be reviewed periodically, no more than quarterly, to assure 
proper payment. A cost settlement at the completion of the fiscal 
period year end is required. Payments in excess of cost are to be 
returned to the Division of Medical Assistance. 

(w) A special payment in addition to the prospective rate shall 
be made in the year that any provider changes from the cash 
basis to the accrual basis of accounting for vacation leave costs. 
The amount of this payment shall be determined in accordance 
with Title XVIII allowable cost principles and shall equal the 
Medicaid share of the vacation accrual that is charged in the year 
of the change including the cost of vacation leave earned for that 
year and all previous years less vacation leave used or expended 
over the same time period and vacation leave accrued prior to 
the date of certification. Tfie payment shall be made as a lump 
sum payment that represents the total amount due for the entire 



fiscal year. An interim payment may be made based on an 
estimate of the cost of the vacation accrual. The payment shall 
be adjusted to actual cost after audit. 

(x) The annual prospective rate, effective beginning each July 
1, for facilities that commenced operations under the Medicaid 
Program subsequent to the base year used to establish rates, and 
therefore did not file a cost report for the base year, shall be 
based on the facility's initial rate, established in accordance with 
Paragraph (m) of this Rule, and the applicable price level 
changes, in accordance with Paragraph (I) of this Rule. 

(y ) Effective for fiscal years beginning on or after fiscal year 
1998. installation cost of Fire Sprinkler Systems in an ICF-MR 
Facility shall be reimbursed in the following manner. 

( 1 ) Upon receipt of the documentation listed in Parts (A) 
through (E) of this Subparagraph, the Division of 
Medical Assistance shall reimburse directly to the 
provider 90 percent of the verified cost. 

(A) All related invoices. 

(B) Verification from the Division of Facility 
Services that the Sprinkler System is needed. 

(C ) Statement from appropriate authorities that the 
Sprinkler System has been installed. 

(D) Three bids to install the system. 

(E) Prior approval from the Division of Medical 
Assistance for any installation projected to cost 
more than twenty-five thousand dollars 
($25,000). 

(2) The unreimbursed installation cost shall be 
reimbursed after audit through the annual Cost 
Settlement Process. This portion shall be offset by 
profits, after taking into consideration any indirect 
profits and direct losses. Any overpayments 
determined after audit shall be returned to the 
program by the provider through the annual cost 
settlement process. 

(3) The installation of the Sprinkler System is subject to 
Prudent Buyer Standards contained in the HCFA-15. 

(4) The Sprinkler System's installation costs shall be 
properly recorded on the provider's ICF-MR Cost 
Report. 

Hisroiy Note: Filed as a Tempormy Amendment Eff. July 8, 

1993 for a period of 180 days or until the permanent rule 

becomes effective, whichever is sooner: 

AiduvmG.S. 108A-25(b): I08A-54; I08A-55: 42 C.F.R. Part 

447. Subpart C: 

Eff. December I. 1984: 

Amended Eff. August 1. 1995: November f 1993: March 1. 

1988:Januanl. 1987: 

Temporaiy Amendment Eff. Sei)teinber 8. 1999: Aimust 7, 1998. 



TITLE 21 - OCCUPATIONAL LICENSING BOARDS 

CHAPTER 37 - BOARD OF NURSING HOME 
ADMINISTRATORS 



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398 



TEMPORARY RULES 



Rule-making Agency: NC State Board of Examiners for 
Nursiii}^ Home Administrators 

Rule Citation: 21 NCAC 37D .0202: 37E .0102: 37F .0102: 
37G .0102, .0201: 37H .0102 

Effective Date: August 15. 1999 

Findings Reviewed and Approved by: Julian Mann. Ill 

Authority for the rule-maliing: G.S. 90-278: 90-280: 90-285: 
90-286: 90-287 

Reason for Proposed Action: The Stare Treasurer pursuant 
to Budget guidelines, requires the Board to maintain a balance 
of $150,000.00 in its account with the State Treasurer Senate 
Bill 622 was introduced and enacted as S.L. 99-0217 to 
authorize the Board to charge additional fees to prevent a 
shortfall in the account. The affected parties will soon be 
submitting their applications, most of which will be approved bv 
the Board after October 1. 1999. the effective date of the 
legislation. Therefore, the affected parries will owe the fees 
after that date. 

Comment Procedures: Written comments max he addressed 
to Jane Baker Execurive Director. 3733 National Drive. Suite 
228. Raleigh. NC 27612. 

SUBCHAPTER 37D - NEW LICENSES 

SECTION .0200 - APPLICATION FOR LICENSE 

.0202 INITIAL LICENSURE FEE 

The applicant shall send to the Beiard. prior to licensure, an 
initial licensure fee of three hundred — twenty f i v e dolla r s 
( $32 5 .00 ) three hundred seventy five ($375.00) when applicant 
has successfully passed the e.xaminations as required hy the 
Board under Sections .0600 and .0700 of this Chapter. 

History Note: Filed as a Temporary Amendment Eff. July 13. 

1982 for a period of 120 days to e.xpire on November 9, 1982: 

Aurhority G.S. 90-280: 

Eff. Februan- 1, 1976: 

Amended Eff. August 1 . 1977: 

Readopted Eff. October 1. 1981: December 15. 1977: 

Amended Eff. February 1. 1991: October 1. 1982: December 30. 

1981: 

Transferred and Recodified from 2 1 NCA C37A. 0302 Eff. April 

I. 1996: 

Amended Eff. August I. 1996: 

Tetnporaiy Amendment Eff. August 15. 1996: 

Amended Eff. July I. 1998: 

Teinporan Anwndment Eft. ,Aui;ust 15, 1W9. 

SUBCH.APTER 37E - RECIPROCITY/ENDORSEMENT 



SECTION .0100 - APPLICATIONS 

.0102 APPLICATION CONTENTS | 

An applicant for reciprocity/endorsement shall submit, thre* 
weeks prior to the personal interview, a ct)mpleicd application, 
background resume, certified college transcript(s), three 
reference forms (one of which shall be from an employer) from 
individuals not related to the applicant who shall certify to the 
good moral character of the applicant as defined in 21 NCAC 
37D .0203, licensing questionnaire(s) from e\ery state where the 
applicant has held a license and a one hu n dred l\\ enty five dollar 
($ 12 5.0 ) two hundred dollar ($200.00) application fee. 

History Note: Authorirs- G.S. 90-280: 90-285: 90-287: 

Eff. February 1, 1976: 

Readopted Eff. December 15, 1977: 

Amended Eff. February- 1, 1980: 

Readopted Eff. October 1, 1981: 

Amended Eff. August 1. 1995: August 2. 1993: February 1. 

1991: May 1, 1989: 

Transferred and Recodijicd from 21 A'C4C 37A .09l2<h> Eff. 

April 1, 1996: 

Amended Eff. Aprdl . 1996: 

Tempor-ar\- Amendment Eff. August 15. 19Q9. 

SUBCHAPTER 37F - TEMPOR.\RY LICENSE 

SECTION .0100 - TEMPORARY LICENSE g 

REQUIREMENTS | 

.0102 ISSUANCE AND RENEW AL OF TEMPORARY 
LICENSE 

(a) An applicant for a temporary license shall request, in 
writing, a temporary license package from the Board, provide a 
letter from the owner or regional manager requesting the issue 
of such license for the facility, stating the circumstances 
necessitating the issuance of a temporary license, and submit a 
completed application package including payment of a ont 
hundred dollar ($100.00) two hundred dollar ($200.00) fee. 

(b) After an applicant is issued a temporary license he shall 
successfully pass the state examination as administered by the 
Board at the next scheduled testing period to retain the 
temporary license. 

(c) A temporary license may be renewed at the discretion of 
the Board for an additional period not to exceed a total of six 
months. 

(d) A temporary license shall be issued to the licensee to 
permit him to practice only in the nursing home to which he is 
assigned on the date of issuance. 

(e) If the Board renews the temporary license, no further fee 
shall be required. 



History Note: Autlwrirv G.S. 90-278: 90-280: 90-285: 
Eff. Februan- 1, 1980: 
Amended Eff. April 15, 1980: 
Readopted Eff. October!, 1981: 



i 



399 



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September 1, 1999 



14:5 



TEMPORARY RULES 



Amended Eff. May 1. 1989: December 1. 1983: October I. 

1982: 
transferred and Recodified from 21 NCAC 37A . 1003 Eff. April 
§7, 1996: 

Amended Eff. April 1 . 1996: 

Temporary Amendment Eft'. Aiieust 15. 1999. 

SUBCHAPTER 37G - RENEWAL, INACTIVE, 

RESTORATION AND REINSTATEMENT, 

DUPLICATE 

SECTION .0100 - RENEWAL REQUIREMENTS 

.0102 RENEWAL FEE 

Upon making application for a new certificate of registration 
a licensee shall pay a biennial licensure fee of three hundred 
t we nt v-fivedollars ($ -' ^25.00). three hundred seventy I'ivedollars 
($375.00). 

History Note: Filed as a Temporary Amendment Eff. Julx 1 3. 

1982 for a period of 120 days to expire on November 9. 1982 ■ 

Aiithorit}- as. 90-280: 90-285: 90-286: 

Eff. Februaiy 1. 1976: 

Amended Eff. August I, 1977: April 8. 1977: 

Readopted Eff. December 15, 1977: 

Readopted w/change Eff. October 1. 1981: 

Amended Eff. Februan- 1. 1991: Max 1. 1989: December 1. 
J983: October 1. 1982: 
transferred and Recodified from 21 NCAC 37A .0904 Eff. AprU 

1. 1996: 

Amended Eff. August 1. 1996: 

Temporaty Amendment Eff. August 15, 1996: 

Amended Eff. July 1 , 1998: 

Temporary- Amendment Eff. Ausu.st 15, 1999. 

SECTION .0200 - INACTIVE LICENSES 

.0201 INACTIVE STATUS REQUIREMENTS 

(a) An inactive list of administrators who arc not practicing 
in this state shall be maintained by the Board. An administrator 
who desires to be placed on the inactive status list shall make a 
■written request and submit a twenty-five do ll a r ($25.00) fifty 
dollar ($50.00) per year fee to the Board. Inactive status shall 
only be granted on a prospective basis. 

(b) A request to be placed on the inactive status list shall be 
submitted to the Board no later than 30 days after expiration of 
the license under 21 NCAC 37G .0101(a). Failure to submit the 
request and payment of the fee within this time shall result in 
automatic expiration of the license retroactive to the expiration 
date. 

(c) An administrator may remain on the inactive list for a 
period not to exceed five four years. 

piston Note: Authority G.S. 90-280: 90-285: 
Eff. February 1. 1976: 
Amended Eff. April 8, 1977: 



Readopted Eff. December 15, 1977: 

Readopted with Change Eff. October 1, 1981: 

Amended Eff. February 1, 1991: 

Transferred and Recodified from 21 NCAC 37A .0906 Eff. April 

1, 1996: 

Amended Eff. AprU 1. 1999: 

Temporarx Amendment Eff. August 15, 1999. 

SUBCHAPTER 37H - CONTINUING EDUCATION 

SECTION .0100 - CONTINUING EDUCATION 
REQUIREMENTS 

.0102 CONTINUING EDUCATION PROGRAMS 
OF STUDY 

(a) The Board shall certify and administer courses in 
continuing education for the professional development of 
nursing home administrators and to enable persons to meet the 
requirements of the rules in this Chapter. The licensee shall 
keep a record of his continuing education hours. Certified 
courses, including those sponsored by the Board, an accredited 
university, college or community college, associations, 
professional societies, or organizations shall: 

( 1 ) contain a minimum of two classroom hours of 
academic work and not more than eight classroom 
hours within a 24-hour period; and 
include instruction in the following general subject 
areas or their equivalents: 
(A) Resident Care Management; 

Personnel Management; 

Financial Management; 

Environmental Management; 

Regulatory Management; 

Organizational Management. 

(b) In lieu of certifying each course offered by a provider, the 
Board may certify the course provider for an annual fee not to 
exceed two thousand dollars ($2,(J00). 

ttO(c) Certified courses not administered by the Board shall; 
(1) 



(2) 



(B) 
(C) 
(D) 
(E) 
(F) 



(2) 



(3) 



be submitted to the Board for approval at least 30 
days prior to the presentation of the program; 
be accompanicii with a fee of fifty dollars ($50.00) to 
cover the cost of reviewing and maintaining records 
associated with the continuing education program; 
and 

be approved for a period of one year from the date of 
initial presentation. 
(c)(d] Courses from an accredited university or community 
college shall meet all requirements as outlined in Paragraphs (a) 
and (h) of this Rule. A licensee submitting such courses for 
continuing education credit shall submit a copy of the final grade 
for said course work. Continuing education credit hours granted 
by the Board shall be the same as those granted by the 
institution. 

td1(e) Credit may be earned for participation in 
teleconfcrenced course only if there is a third party 
representative of the course sponsor or the Board present to 



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400 



— 



l^ 



TEMPORARY RULES 



\ erify the licensee's attendance throughout the course. No credit 
shall be earned tor correspondence courses. 

tejiij The Board shall charge a registration fee covering the 
cost of continuing education courses it sponsors, not to exceed 
two hundred titty dollars ($250.00). 

History Note: Authority G.S. 12-3. J(c)(3): 90-278: 90-280: 

90-285: 90-286: 

Ejf. Felmian I. 1976: 

Amended Eff. April 8, 1977: 

Readopted Eff. December 15, 1977: 

Readopted w/change Ejf. October 1. 1981: 

Amended Ejf. August 2. 1993: Fehruarx 1. 1991: Max 1. 1989: 

Februaiy 1. 1986: 

Transferred and Recodified from 21 NCAC 37A .0404 Eff. April 

1. 1996: 

Temporan- Amendment Eff. August 15, 1999. 



I 



i 



401 NORTH CAROLINA REGISTER September /, 1999 14:5 



APPROVED RULES 



» 



This Section includes the Register Notice citation to Rules approved by the Rules Review Commission (RRCj a! its meeting of 
June 17, 1 999 pursuant to G.S. 150B-21 .17{a){l ) and reported to the Joint Legislative Administrative Procedure Oversight 
Conmiittee pursuant to G.S. I50B-21.16. The full text of rules are published below when the rules have been approved by RRC 
in a form different from that originally noticed in the Register or when no notice was required to be published in the Register. 
The rides published in full text are identified by an * //; the listing of approved rules. Statutory Reference: G.S. 150B-21.17. 



These rules unless othenvise noted, will become effective on the 31st legislative day of the 2000 Session of the General Assembly 
or a later date if specified by the agency unless a bill is introduced before the 31st legislative day that specifically disapproves 
the rule. If a bill to disapprove a rule is not ratified, the rule will become effective either on the day the bill receives an 
unfavorable final action or the day the General Assembly adjourns. Statutory reference: G.S. I50B-2 1.3. 



APPROVED RULE CITATION 



REGISTER CITATION TO THE 
NOTICE OF TEXT 



» 



) 



12 


NCAC 


09B 


.0109-.01IO* 


12 


NCAC 


09B 


.0112* 


12 


NCAC 


09B 


,0115* 


12 


NCAC 


098 


,0207-.02O8 


12 


NCAC 


09B 


,0302-0304* 


12 


NCAC 


09B 


,0312 


12 


NCAC 


()9B 


,0403 


12 


NCAC 


09B 


,0406* 


12 


NCAC 


09B 


,0407 


12 


NCAC 


()9B 


,0414* 


12 


NCAC 


09B 


,0415 


12 


NCAC 


09C 


,0403 


12 


NCAC 


09E 


,0107 


12 


NCAC 


lOB 


,0505-,05O9 


12 


NCAC 


lOB 


,0703 


12 


NCAC 


lOB 


,0908 


12 


NCAC 


lOB 


,1002 


12 


NCAC 


JOB 


,1401 


12 


NCAC 


lOB 


,1402-, 1405* 


12 


NCAC 


lOB 


.1406 


15A 


NCAC 


031 


,0107* 


15A 


NCAC 


03Q 


,0106* 


15A 


NCAC 


07H 


.2404* 


15A 


NCAC 


lOB 


,0109* 


15A 


NCAC 


JOB 


,0204* 


21 


NCAC 


14A 


.0101* 


21 


NCAC 


i4A 


.0103* 


21 


NCAC 


i4A 


.0105 


21 


NCAC 


i4A 


.0202* 


21 


NCAC 


i4F 


.0101* 


21 


NCAC 


I4F 


.0105* 


21 


NCAC 


I4G 


.0103* 


21 


NCAC 


141 


.0109* 


21 


NCAC 


14J 


.0103 


21 


NCAC 


14K 


,0102* 


21 


NCAC 


I4K 


,0107* 


21 


NCAC 


I4L 


,0105 


21 


NCAC 


14L 


,0216* 


21 


NCAC 


]4N 


,0101-,0105* 


21 


NCAC 


14N 


.0108 


21 


NCAC 


]4N 


.0110* 


21 


NCAC 


14N 


.0112* 



13:19NCR 161 1 




13:19NCR 161 1 




13:19 NCR 1611 




13:19NCR 1611 




13:19 NCR 1611 




13:19 NCR 1611 




13:19NCR 1611 




13:19 NCR 1611 




13:19 NCR 1611 




13:19 NCR 1611 




13:19 NCR 1611 




13:19NCR 1611 




13:19 NCR 1611 




13: 19 NCR 1636 




13: 19 NCR 1636 




13: 19 NCR 1636 




13: 19 NCR 1636 




13: 19 NCR 1636 




13: 19 NCR 1636 




13: 19 NCR 1636 




not required. G.S, 1508-21,4. 


1508-21. 5(a)(2) 


not required. G,S, 1508-21,4. 


1508-2 1.5(a)(2) 


13: 13 NCR 1047 




not required, G,S, 1508-21,4. 


1508-2 1.5(a)(2) 


not required. G.S. 1508-21.4, 


1508-21. 5(a)(2) 


13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13: 1 9 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 




13:19 NCR 1652 




13: 19 NCR 1652 




13: 19 NCR 1652 





14:5 



NORTH CAROLINA REGISTER 



September 1, 1999 



402 



^^sm 



APPROVED RULES 



1 1 


NCAC 


14N 


.0601 -.0602 


1 ] 


NCAC 


14N 


.O7O1-.0702 


T 1 


NCAC 


I40 


.0102-.0103 


2 1 


NCAC 


I40 


.0106* 


T 1 


NCAC 


140 


.0107 


T 1 


NCAC 


I4P 


.0101-.0104 


~l 1 


NCAC 


I4P 


.0106-.0109 


T 1 


NCAC 


14P 


.0110* 


1 


NCAC 


14P 


.0115* 



13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 


13 


19 NCR 


1652 



TITLE 12 - DEPARTMENT OF JUSTICE 

CHAPTER 9 - CRIMINAL JUSTICE EDUCATION 
AND TRAINING STANDARDS 

SUBCHAPTER 9B - STANDARDS FOR CRIMINAL 

JUSTICE EMPLOVMENT:EDUCATION: AND 

TRAINING 

SECTION .0100- MINIMUM STANDARDS FOR 
CRIMINAL JUSTICE EMPLOYMENT 

.0109 MINIMUM STANDARDS FOR 

PROBATION/PAROLE OFFICERS 

In addition \o the requirements tor criminal justice officers 
contained in Rule .0101 ol this Section, every probation/parole 
officer employed by an agency in North Carolina shall: 

(1) not have committed or been convicted of a felony; 
and 

(2) be a graduate of an accredited college or university, 
which is accepted by the American Council on 
Education (ACE ) for the Commission on Recognition 
of Postsecondary Accreditation (CORPA) as 
accredited, and have attained at least the baccalaureate 
degree. 

Histon Note: Authority G.S. I7C-6: 

Ejf. January 1. 1981: 

Amended Eff. August I. 2000: December I. 1987. 

.0110 MINIMUM STANDARDS FOR 

PROBATION/PAROLE INTAKE OFFICERS 

In addition to the requirements for criminal justice officers 
contained in Rule .(JlOl of this Section, every probation/parole 
intake officer employed hy an agency in North Carolina shall: 

(1) not have committed or been convicted of a felony; 
and 

(2) have attained the associate degree or have 
satisfactorily completed at least 60 semester hours of 
educational credit or 90 quarter hours of educational 
credit at an accredited technical institute, technical 
college, community college, junior college, college, or 
university, which is accepted by the .American 
Council t)n Education (ACE) for the Commission on 
Recognition of Postsecondarv Accreditation 



(CORPA) as accredited. 

History Note: Authority G.S. 17C-6\ 

Eff. Januan- 1. 1981: 

Amended Ejf. August I. 2000: December I. 1987. 

Ann MINIMUM STANDARDS FOR PAROLE CASE 
ANALYSTS 

In addition to the requirements for criminal justice officers 
contained in Rule .0101 of this Section, every parole case 
analyst employed by an agency in North Carolina shall: 

(1) not have committed or been convicted of a felony: 
and 

(2) be a graduate of an accredited college or university, 
which is accepted by the American Council (in 
Education (Ace) for the Commission on Recognition 
of Postsecondary Accreditation (CORPA) 
accredited. and have attained at least the baccalaureat' 
degree. 

History- Note: Authorit\ G.S. 17C-6: 

Eft: April I. 1983: 

Amended Eff. Auzusi 1 . 2000: December 1. 1987. 

.0115 MINIMUM STANDARDS 

PROBATION/PAROLE INTENSIVE OFFICER 

In addition to the requirements for criminal justice officers 
contained in Rule .0101 of this Section, every probation/parole 
intensive officer employed by an agency in North Carolina shall : 

(1) not ha\e committed or been convicted of a felony: 
and 

(2) be a graduate of an accredited college or university, 
which is accepted by the American Council on 
Education (ACE) for the Commission on Recognition 
of Postsecondary Acceditation (CORPA i as 
accredited, and have attained at least the baccalaureate 
degree. 

Histoiy Note: Authority G.S. 17C-6: 
Eff. Febriuin I. 1987: 
Amended Eft Aumsi I. 2000. 

SECTION .0300 - MINIMUM STANDARDS FOR % 
CRIMINAL JUSTICE INSTRUt TORS 



403 



NORTH CAROLINA REGISTER 



September I, 1999 



14:5 



APPROVED RULES 



.0302 GENERAL INSTRUCTOR CERTIFICATION 

Certifications issued in this category after December 31, 1984 
^hall be limited to those topics which are not expressly 
Picorporated under the Specific InstructorCertitlcation category. 
Indi viduals certified under the general instructor category are not 
authorized to teach any of the subjects specified in Rule .0304, 
entitled "Specific Instructor Certification". To qualify for 
issuance of General Instructor Certification, an applicant shall 
demonstrate a combination of education and experience in 
criminal justice and proficiency in the instructional process to 
the satisfaction of the Commission. At a minimum, the 
applicant shall meet the following requirements for General 
Instructor Certification: 

(1) Present documentary evidence showing that the 
applicant: 

(a) is a high school graduate, or has passed the 
General Education Development Test (GEO) 
indicating high school equivalency, and has 
acquired four years of practical experience as 
a criminal justice officer or as an administrator 
or specialist in a field directly related to the 
criminal justice system; or 

( b ) has been awarded an associate degree and has 
acquired three years of practical experience as 
a criminal justice officer or as an administrator 
or specialist in a field directly related to the 
criminal justice system: or 

(c) has been awarded a baccalaureate degree and 
m has acquired two years of practical experience 

as a criminal justice officer or as an 
administrator or specialist in a field directly 
related to the criminal justice system; or 

(d) has been awarded a graduate/professional 
degree and has acquired one year of practical 
experience as a criminal justice officer or as an 
administrator or specialist in a field directly 
related to the criminal justice system. 

(2) Present evidence showing successful completion of a 
commission-accredited instructor training program or 
an equivalent instructor training course utilizing the 
Instructional Systems Design model, an international 
model with applications in education, military 
training, and private enterprise. 

(a) applications for General Instructor 
Certification shall be submitted to the 
Standards Division within 60 days of the date 
the applicant successfully passed the state 
comprehensive examination administered at 
the conclusion of the commission-accredited 
instructor training program or an equivalent 
instructor training course utilizing the 
Instructional Systems Design model, an 
international model with applications in 

'k education, military training, and private 

enterprise. 

(b) persons having completed a commission- 
accredited instructor training course or an 



equivalent instructor training course utilizing 
the Instructional Systems Design model, and 
international model with appplications in 
education, military training, and private 
enterprise, and not having made application 
within 60 days of completion of the course 
shall complete a subsequent commission- 
accredited instructor training course in its 
entirety. 



Histoiy Note: Authority G.S. 17C-6; 

Eff. Jaiman- I. 19HI: 

Amended Eff. Aimist 1. 2000; Jid\ I. 1991; December 1 . 1987; 

October I. 1985; Jaiuiurx I. 1985. 

.0303 TERMS AND CONDITIONS OF GENERAL 
INSTRUCTOR CERTIFICATION 

(a) An applicant meeting the requirements for certification as 
a general instructor shall, for the first 1 2 months of certification, 
be in a probationary status. The General Instructor C jfication. 
Probationary Status, shall automatically expire 12 months from 
the date of issuance. 

(b) The probationary instructor will be eligible for full 
general instructor status, if the instructor through application at 
the end of the probationary period, submits to the Commission: 

( 1 ) a favorable recommendation from a school director 
accompanied by certification on a 
commission-approved Instructor Evaluation Form that 
the instructor successfully taught a minimum of eight 
hours in a commission-accredited course or a 
commission-recognized in-service training course 
during the probationary year. The results of the 
student evaluation of the instructor must be 
considered by the school director when determining 
recommendation; or 

(2) a favorable written evaluation by a commission or 
staff member, based on an on-site classroom 
evaluation of the probationary instructor in a 
c o m m i s s i o n - a c c r c d i t e d course or a 
commission-recognized in-service training course. 
Such evaluation will be certified on a 
commission-approved Instructor Evaluation Form. In 
addition, instructors evaluated by a commission or 
staff member must also teach a minimum of eight 
hours in a ci'inmission-accredited training course or 
a commission-recognized in-service training course. 

(c) The term of certification as a general instructor is two 
years from the dale the Commission issues the certification. The 
certification may subsequently be renewed by the Commission 
for two-year pcriiids. The application for renewal shall contain, 
in addition to the requirements listed in Rule .0302 of this 
Section, documentary evidence indicating that the applicant has 
remained active in the instructional process during the previous 
two-year period. Such documentary evidence shall include 
proof that the applicant has, within the two-year period 
preceding application Un renewal, instructed a minimum of eight 



14:5 



NORTH CAROLINA REGISTER 



September I, 1999 



404 



APPROVED RULES 



hours in a commission-accredited training course or a 
commission-recognized in-service training course; and either 

( 1 ) a favorable written recommendation from a school 
director accompanied by certification on a 
commission-approved Instructor Evaluation Form that 
the instructor successfully taught a minimum of eight 
hours in a commission-accredited training course or 
a commission-recogni/ed in-service training course 
during the two-year period of general certification: or 

(2) a favorable evaluation by a commission or staff 
member, based on an on-site classroom evaluation of 
a presentation by the instructor in a 
commission-accredited training course or a 
commission-recognized in-service training course, 
during the two-year period of General Instructor 
Certification. In addition, instructors evaluated hy a 
commission or staff member must also teach a 
minimum of eight hours in a commission-accredited 
training course or a commission-recognized in-service 
training course. 

(d) All instructors shall remain active during their period of 
certification. If an instructor does not teach a minimum of eight 
hours during the period of certification, the certification shall not 
be renewed, and the instructor shall file application for General 
Instructor Certification, Probationary Status. Such applicants 
shall be required to meet the minimum requirements of Rule 
.0302 of this Section. 

(e) The use of guest participants in a delivery of the Basic 
Law Enforcement Training Course is permissible. Howe\er. 
such guest participants are subject to the direct on-site 
supervision of a commission-certified instructor and must be 
authorized by the school director. A guest participant shall only 
be used to complement the primary certified instructor of the 
block of instruction and shall in no way replace the primary 
instructor. 

(f) For purposes of this Section, "commission-recognized 
in-service training" shall mean any training for which the 
instructor is e\aluated by a certified school director on a 
commission-approved Instructor Evaluation Form. Such 
training shall be objective based and documented hy lesson 
plans designed consistent with the Basic Law Enforcement 
Training format and documented by departmental training 
records to include required post-test and testing methodology. 
The signature of the school director on the 
Commission-approved Instructor Evaluation Form shall verily 
compliance with this Rule. 

History Note: Authoritx G.S. I7C-6: 

Eff.Janiian- I. 1981: 

Amended Eff'. August I. 2000: Juh I, 1991: October 1. 1985; 

January I. 1985. January 1 , 1983. 

.0304 SPECIALIZED INSTRUCTOR 
CERTIFICATION 

(a) The Commission may issue a Specialized Instructor 
Certification to an applicant who has developed specific 



motor-skills and abilities by virtue of special training and 
demonstrated experience in one or more of the following topical 
areas: ^ 

(1) Subject Control Arrest Techniques * 

(2) First Responder 

(3) Firearms 

(4) Law Enforcement Driver Training 
(3) Physical Fitness 

(6) Firearms (DOC) 

(7) Unarmed Self-Defense (DOC/DYS ) 

(8) Medical Emergencies (DYS) 

(9) Electrical and Hazardous Materials Emergencies 

(b) To qualify for Specialized Instructor Certification, with 
the exception of the First Responder, Physical Fitness, Youth 
Services Medical Emergencies, and Electrical and Hazardous 
Materials Emergencies topical areas as outlined in Rule .0304 
(d), (e), (f) and (g) of this Section, an applicant must meet the 
following requirements: 

(1) hold General Instructor Certitlcaticm, either 
probationary status or full general instructor status, as 
specified in Rule .0303 of this Section: and 

(2) successfully complete the pertinent 
commission-approved specialized instructor training 
course; and 

(3) obtain the recommendation of a 
commission-recognized school director. 

(c) To qualify for and maintain an) Specialized Instructor 
Certification, an applicant must possess a valid CP^ 
Certification that included cogniti\e and skills testing. ^ 

(d) To qualify for Specialized Instructor Certification in the 
First Responder topical area, an applicant is not required to meet 
the standards for issuance of General Instructor Certification, but 
must qualify through one of the following two options: 

( 1 ) The first option is: 

(A) hold current CPR instructor certification 
through either the American Red Cross or the 
American Heart Association; and 

(B) hold current basic Emergency Medical 
Technician certification; and 

(C) have successfully completed the Department of 
Transportation's 40 hour EMT Instructor 
Course or equivalent within the last three years 
or hold a current North Carolina teaching 
certificate. 

(2) The second option is: 

(A) hold General Instructor Certification, either 
probationary status or full general instructor 
status, as specified in Rule .0303 (){ this 
Section; and 

(B) hold current CPR instructor cerlificalion 
through either the American Red Cross in the 
American Heart Association: and 

(C) hold current basic EMT certi fication. 

(e) To qualify for Specialized Instructor Ccrtilicalion in t 
Physical Fitness topical area, an applicant may become certified 
through one of the following two methods: 



1 

led 



405 



NORTH CAROLINA REGISTER 



September L 1999 



14:5 



APPROVED RULES 



( 1 ) The first method is' 

(A) hold General Instructor Certification, either 
^ probationary status or full general instructor 
■ status, as specified in Rule .0303 of this 

Section; and 

(B) successfully complete the pertinent 
commission-approved specialized instructor 
training course; and 

(C) obtain the recommendation of a 
commission-recognized school director. 

(2) The second method is: 

(A) successfully complete the pertinent 
commission-approved specialized instructor 
training course; and 

(B) obtain the recommendation of a 
commission-recognized school director; and 

(C) in addition to the requirements of both (2), (A) 
and (B) of this Rule, the applicant must meet 
one of the following qualifications: 

(i) hold a current and valid North Carolina 
Teacher's Certificate and hold a 
minimum of a baccalaureate degree in 
physical education and be actively 
teaching in physical education topics; or 
(ii) be presently instructing physical 
education topics in a community 
college, college or university and hold a 
minimum of a baccalaureate degree in 
% physical education. 

(f) To qualify for Specialized Instructor Certification in the 
Electrical and Hazardous Materials Emergencies topical area, an 
applicant is not required to meet the standards for issuance of 
General Instructor Certification, but must qualify through one of 
the following two options: 

(1) The first option is: 

(A) hold current instructor certification as a First 
Responder Awareness Level Hazardous 
Materials instructor; and 

(B) have successfully completed the Fire Service 
Instructor Methodology Course or the 
equivalent utilizing the Instructional Systems 
model, an international model with 
applications in education, military training, and 
private enterprise. 

(2) The second option is: 

(A) hold General Instructor Certification, either 
probationary status or full general instructor 
status, as specified in Rule .0303 of this 
Section; and 

( B ) have successfully completed a First Responder 
Awareness Level Hazardous Materials course. 

(g) To qualify for Specialized Instructor Certification in the 
State Youth Services Medical Emergencies topical area, an 

■applicant is not required to meet the standards for issuance of 
General Instructor Certification, but must qualify in the 
following manner: 

( 1 ) havesuccessfully completed a commission-accredited 



basic instructor training course or an equivalent 
instructor training course utilizing the Instructional 
Systems Design model, an international model with 
applications in education, military training, and 
private enterprise, within the 12 month period 
preceding application; and 
(2) hold current instructor certification in CPR and First 
Aid by fulfillment of the American Red Cross 
Instructor requirements. 

HistonNore: Authorin G.S. 17C-6: 

Eff. January I. 1981: 

Amended Eff: Aiiijust 1. 200U; July J. 1991: March 1. 1990: July 

1. 1989: December 1, 1987. 

SECTION .0400 - MINIMUM STANDARDS FOR 
COMPLETION OF TRAINING 

.0406 COMPREHENSIVE W RITTEN 

EXA^^NATION BASIC LAW ENFORCEMENT 
TRAINING 

(a) At the conclusion of a schools offering of the Basic Law 
Enforcement Training Course in its entirety, the Commission 
shall administer a comprehensive written examination to each 
trainee who has satisfactorily completed all of the required 
course work. A trainee shall not be administered the 
comprehensive written examination until such time as all of the 
course work is completed. 

(b) The examination shall be comprised of six units as 
specified in 1 2 NCAC 9B .0205(a). Each unit is designed to test 
the trainees' proficiency in that unit. 

(c) The Commission's representative shall submit to the 
school director within five days of the administration of the 
examination a report of the results of the test for each trainee 
examined. 

(d) A trainee shall have successfully completed the 
comprehensive written examination upon achieving a minimum 
of 70 percent correct answers on each of the six units as 
prescribed in 1 2 NCAC 9B .0406(b). 

(e) A trainee who has fully participated in a scheduled 
delivery of an accredited training course and has demonstrated 
satisfactory competence in each motor-skill or performance area 
of the course curriculum but has failed to achieve the minimum 
score of 70 percent on no more than two units of the 
Commission's comprehensive written examination may request 
the Director of the Standards Division to authorize a 
re-examination of the trainee in only those units for which 
he/she failed to make a passing score of 70 percent: 

(1 ) The trainee's request for re-examination shall be made 
in writing on the Commission's form and shall be 
received by the Standards Division w ithin 30 days of 
the examination. 

(2) The trainee's request for re-examination shall include 
the favorable recommendation of the school director 
who administered the course(s). 

(3) A trainee shall have, within 90 days of the original 



14:5 



NORTH CAROLINA REGISTER 



September I, 1999 



406 



1^ 



APPROVED RULES 



examination(s), only one opportunity for 
re-examination and shall satisfactorily complete the 
subsequent unit examination in its entirety. 

(4) The trainee will be assigned in writing by the Director 
of the Standards Division a place, time, and date for 
re-examination. 

(5) Should the trainee on re-examination not achieve the 
prescribed minimum score on the examination, the 
trainee may not be given successful course 
completion and shall enroll and successfully complete 
a subsequent offering of the Basic Law Enforcement 
Training Course in its entirety. 

(f) A trainee who fails to achieve a passing score of 70 
percent on three or more of the units as prescribed in 1 2 NCAC 
9B .0406(b) shall not be given the opportunity for re- 
examination on those units: and shall enroll in and successfully 
complete a subsequent offering of the Basic Law Enforcement 
Training Course in its entirety. 

Histoi-\- Note: Aiithorin G.S. J 7C-6: 17C-10.: 

Eff. Juiuuin /. 1981: 

Amended Eff. August L 2000: Juh I. 1989: Julx 1. 1985: 

Jamtm-y 1. 1983. 

.0414 COMPREHENSIVE WRITTEN EXAM -- 
SPECIALIZED INSTRUCTOR TRAINING 

(a) At the conclusion of a school's offering of the 
"Specialized Firearms Instructor Training" course. "Specialized 
Driverlnstructor Training" course, "Specialized Subject Control 
Arrest Techniques Instructor Training" course. "Specialized 
Physical Fitness Instructor Training" course, the "Radar 
Instructor Training Course," the "Criminal Justice TD/SMI 
Instructor Training Course." the "Re-Certification Training for 
Radar Instructors" course, and the "Re-Certification Training for 
TD/SMI Instructors" course, in its entirety, the Commission 
shall administer a comprehensive written examination to each 
trainee who has satisfactorily completed all of the required 
course work. A trainee cannot be administered the 
comprehensive written examination until such time as all of the 
pertinent course work is completed. 

(b) The examination shall be an objective test consisting of 
multiple-choice, true-false, or similar questions covering the 
topic areas contained in the accredited course curriculum. 

(c) The Commission's representative shall submit to the 
school director within five days of the administration of the 
examination a report of the results of the test for each trainee 
examined. 

(d) A trainee shall successfully complete the comprehensive 
written examination if he/she achieves a minimum of 75 percent 
correct answers. 

(e) A trainee who fails to achieve the minimum score of 75 
percent on the Commission's comprehensive written 
examination shall not be given successful course completion and 
shall enroll and successfully complete a subsequent offering of 
the specialized instructor training course in its entirety before 
further examination may be permitted. 



c 



HIsronNote: Authority G.S. 17C-6: 17C-I0: 

Eff. Fehvuaiy 1. 1987: 

Amended Eff. August !_, 2000: Julx 1. 1989. 

CHAPTER 10 - SHERIFFS' EDUCATION AND 
TRAINING STANDARDS CO.MMISSION 

SUBCHAPTER 108 - N.C. SHERIFFS' EDUCATION 
AND TRAINING STANDARDS CO.MMISSION 

SECTION .1400 - PROFESSIONAL CERTIFICATE 
PROGRAM FOR RESERVE DEPUTY SHERIFFS 



.1402 GENERAL PROVISIONS 

(a) In order to be eligible for one or more of the professional 
certificates, a reserve deputy sheriff shall first meet the 
following preliminary qualifications: 

(1) Be an appointed reserve deputy sheriff who holds 
valid General or Grandfather Certification. A reserve 
deputy sheriff serving under a probationary 
certification is not eligible for consideration. 

(2) Be familiar with and subscribe to the Law 
Enforcement Code of Ethics as promulgated by the 
International Association of Chiefs of Police to 
include any subsequent editions or modifications 
thereto. A copy of the Code of Ethics may be 
obtained at no cost from the Sheriffs' Standards 
Division, North Carolina Department of Justice, Pos* 
Office Box 629, Raleigh. North Carolina 27602-06291 

(3) The applicant shall be a sworn law enforcement 
officer of a North Carolina Sheriffs Office, as 
certified in writing by the sheriff: or be a sworn law- 
enforcement officer of an agency who must be 
appointed by the sheriff in order to perform his duties 
as certified in writing by the Sheriff. 

(4) Only training or experience gained in an officer's area 
of expertise will be eligible for application to this 
program. All training must be completed during the 
time of service as a sworn law enforcement officer, 
with the exception of Basic Law Enforcement 
Training. 

(b) Certificates are awarded based upon a formula v\hich 
combines law enforcement training and actual participation as a 
reserve deputy sheriff in law enforcement functions. Points arc 
computed in the following manner: 

( 1 ) A minimum of ninety-six (96) hours achieved over a 
one-year period of participation in law enforcement 
functions, by having been called into reser\eduty by 
the appointing sheriff, shall equal one year of reserve 
service: 

(2) Twenty hours of comnii^sion-appro\cd law 
enforcement training shall equal one law enforcement 
training point: ^ 

(3) Service as a reserve deput\ sheriff shall he acceptably 
for consideration: or an officer who is otherwise 
ineligible to receive an equivaleiii certificate through 



407 



NORTH CAROLINA REGISTER 



September L 1999 



14:5 



APPROVED RULES 



i 



the Professional Certificate Program for Sheriffs and 
Deputy Sheriffs as set out in 12 NCAC lOB .1000 
may receive a certitlcale under this program, in which 
case one year of full-time service may he substituted 
for one year of reserve service in computing 
eligibility under this section. 



History Note: Authority G.S. I7E: 
Eff. August I, 2000. 



History Note: Authorin G.S. I7E:. 
Eff. August 1. 2000. 

TITLE 15A - DEPARTMENT OF ENVIRONMENT 
AND NATURAL RESOURCES 

CHAPTER 3 - MARINE FISHERIES 

SUBCHAPTER 31 - GENERAL RULES 



.1403 BASIC RESERVE DEPUTY SHERIFF 
PROFESSIONAL CERTIFICATE 

In addition to the qualifications set forth in Rule .1402, an 
applicant for the Basic Reserve Deputy Sheriff Certificate shall: 

( 1 ) have no less than one year of reserve service; 

(2) and have either; 

(A) successfully completed a 
commission-accredited basic law enforcement 
training course; 

(B) any remedial training as required by the 
Commission for general certification; or 

(3) have completed a minimum of 160 hours of training 
in the field of law enforcement. 



History Note: Authority G.S. 17E: 
Eff. August 1. 2000. 



* 



.1404 INTERMEDIATE RESERVE DEPUTY 
SHERIFF CERTIFICATE 

In addition to the qualifications set forth in Rule .1402, 
applicants for the Intermediate Reserve Deputy Sheriff 
Certificate shall possess or be eligible to possess the Basic 
Reserve Deputy Sheriff Certificate and shall have acquired the 
following of law enforcement training points and years of 
service as a reserve law enforcement officer: 

( 1 ) 8 years of reserve officer law enforcement experience; 
and 

(2) 35 points minimum reserve officer law enforcement 
training. 

Histoiy Note: Authority G.S. I7E: 
Eff: August 1. 2000. 



.1405 ADVANCED RESERVE DEPUTY SHERIFF 
CERTIFICATE 

In addition to the qualifications set forth in Rule .1402. 
applicants for the Advanced Deputy Sheriff Certificate shall 
possess or be eligible to possess the Intermediate Reserve 
Deputy Sheriff Certificate and shall have acquired the following 
law enforcement training points and years of service as a reserve 
law enforcement officer: 

( 1 ) 12 years of reserve officer law enforcement 
experience; and 
■ (2) 50 points minimum total of reserve officer law 
enforcement training. 



SECTION .0100 - GENERAL RULES 

.0107 ENDANGERED OR THREATENED SPECIES 

(a) Pursuant to a cooperative agicement entered into on 
February 5, 1979, by the Department of Environment and 
Natural Resources, the Marine Fisheries Commission, and the 
Wildlife Resources Commission, the Wildlife Resources 
Commission will exercise regulatory jurisdiction over any 
species of sea turtle, and their eggs and nests, consistent with 
designation of such species as endangered or threatened by the 
U.S. Fish and Wildlife Service. As provided hy said agreement, 
the law enforcement officers of both the Marine Fisheries 
Division and the Wildlife Resources Commission have 
jurisdiction to enforce any State laws and rules, including those 
contained in 15A NCAC 101, relating to endangered or 
threatened species of sea turtles and their eggs and nests. 

(b) The Fisheries Director may close or restrict by 
proclamation any coastal waters with respect to taking or 
attempting to take any or all kinds of marine resources when the 
method (equipment) used is a serious threat to an endangered or 
threatened species listed pursuant to 16 USC 1533(c). Copies of 
this list may be obtained from the Division of Marine Fisheries, 
PC Box 769, 3441 Arendell St., Morehead City, North Carolina 
28557-0769. 

(c) It is unlawful to use any commercial fishing equipment in 
the sea turtle sanctuary located in the Atlantic Ocean adjacent to 
Onslow County as described in 1 5A NCAC 3R .0101 from June 
1 through August 3 1 , except that the Fisheries Director may, by 
proclamation, modify the sanctuary within the described area 
and vary implementation between specified dates for the 
protection of the sea turtle population. 

HistonNote: Authority G.S. 113-132: lB-134: 113-134.1: 

113-182: 113-189: 143B-289.52: 

Eff. Jamuvy 1. 1991: 

Recodified from I5A NCAC 31 .0007 Eff. December 17. 1996: 

Amended Eff. Julx I, 1999: Max 1. 1997. 

SUBCHAPTER 3Q - JURISDICTION OF AGENCIES: 
CLASSIFICATION OF WATERS 

SECTION .0100 - GENERAL REGULATIONS: .JOINT 

.0106 APPLICABILITY OF RULES: JOINT WATERS 

(a) All coastal fishing laws and regulations administered by 
the Department of Environment and Natural Resources and the 



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Marine Fisheries Commission apply to joint waters except as 
otherwise provided, and shall be enforced by fisheries 
enforcement officers. 

(b) The following inland fishing laws and regulations 
administered by the Wildlife Resources Commission apply to 
joint waters and shall be enforced by wildlife enforcement 
officers: 

(1) all laws and regulations pertaining to inland game 
fishes, 

(2) all laws and regulations pertaining to inland fishing 
license requirements for hook and line fishing. 

(3) all laws and regulations pertaining to hook and line 
fishing except as hereinafter provided. 

Histon-Note: Authoriry G.S. 113-132: 113-134: 

143B-289.52: 

Eff. Jamiury 1. 1991: 

Amended Eff. Jiih 1. 1999. 

CHAPTER 7 - COASTAL MANAGEMENT 

SUBCHAPTER 7H - STATE GUIDELINES FOR 
AREAS OF ENVIRONMENTAL CONCERN 

SECTION .2400 - GENERAL PERMIT FOR 

PLACEMENT OF RIPRAP FOR WETLAND 

PROTECTION IN ESTLARINE AND PUBLIC 

TRUST WATERS 

.2404 GENERAL CONDITIONS 

(a) This permit authorizes only the construction of wetland 
protection structures conforming to the standards herein. 

(b) Individuals shall allow authorized representatives of the 
Department of Environment and Natural Resources (DENR) to 
make periodic inspections at any time deemed necessary in order 
to be sure that the activity being performed under authority of 
this general permit is in accordance with the terms and 
conditions prescribed herein. 

(c) There shall be no unreasonable interference with 
navigation or use of the waters hy the public by the existence of 
the riprap structure authorized herein. 

(d) This permit shall not be applicable to proposed 
construction where the Department has determined, based on an 
initial review of the application, that notice and review pursuant 
to G.S. 1 1.3A-1 19 is neccesary because there are unresolved 
questions concerning the proposed activity's impact on 
adjoining properties or on water quality; air quality: coastal 
wetlands; cultural or historic sites; wildlife; fisheries resources; 
or public trust rights. 

(e) This permit does not eliminate the need to obtain any 
other required state, local, or federal authorization. 

(f) Development carried out under this permit must be 
consistent with all local requirements, AEC Guidelines, and 
local land use plans current at the lime of authorization. 

Histon-Note: Anthorirx G.S. 1I3A-I07: I13A-II8.I: 



Eff. Aiifiust 1, 2000. 

CHAPTER 10 - WILDLIFE RESOURCES AND g 
WATER SAFETY % 

SUBCHAPTER lOB - HUNTING AND TRAFPINC; 

SECTION .0100 - GENERAL REGULATIONS 

.0109 CHASING DEER BY DOGS IN CERTAIN 
COUNTIES 

It is unlawful to allow dogs to run or chase deer or to attempt 
to take deer with dogs at any time in Alamance County south of 
1-85; Orange County south of 1-85; Chatham County; Lee 
County; Wake County south of NC 98; and in and west of 
Rockingham, Guilford, Randolph and Montgomery Counties 
and that part of Anson County west of NC 742. 
Note: See 15A NCAC lOD .0103 which prohibits any hunting 
with dogs on game lands during the season for hunting deer with 
guns in and west of these counties. 

History Note: Authority G.S. 1 13-134: 1 1 3-291.5: 

Ejf. Febriiaiy 1. 1976: 

Amended Eff. Jiih 1. 1999: Jiih 1. 1991 : Augu.st I. 1980: August 

1. 1 978: August 1. 1977. 

SECTION .0200 - HUNTING 

.0204 WILD BOAR (BOTH SEXES) f 

(a) Open Seasons: Monday on or nearest October 15 to the 
Saturday before Thanksgiving, and the third Monday after 
Than ksgi ving to January 1 , except on bear sanctuaries located on 
the game lands, where the boar seasons are controlled by 15A 
NCAC 10D.0103. 

(b) Bag Limits: Daily, one; possession, one; season, two. 

(c) Kill Reports. The carcass of each wild boar shall be 
tagged and the kill reported as provided by 15A NCAC lOB 

.on 3. 

History Note: Authorit\G.S 113-134:113-270.3: 113-276.1: 

113-291.2: 

Ejf. February I. 1976: 

Amended Eff. Jul\ 1. 1999: Julx I. 1995: Julx I. 1993: Julx I. 

1987: Julx 1. 1986. 

TITLE 21 - OCCUPATIONAL LICENSING BOARDS 

CHAPTER 14 - BOARD OF COSMETIC ART 
EXAMINERS 



SUBCHAPTER 14A - DEPARTMENTAL RULES 
SECTION .0100 - ORGANIZATIONAL RULES 

.0101 DEFINITIONS 

The following definitions apply in this Chapter: 



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$ 



( 1 ) "Beauty Establishment" refers to both cosmetic art 
schools and cosmetic art shops. 

(2) "Cosmetology School" is any cosmetic art school 
which teaches cosmetic art as defined by G.S. 88B- 
2(5), but is not a manicurist school. 

(3) "Manicurist School" is a cosmetic art school which 
teaches only the cosmetic arts of manicuring. 

(4) "Manicurist Student" is a student in any cosmetic art 
school whose study is limited to the manicurist 
curriculum set forth in 21 NCAC I4K .0102. 

(5) "Successful Completion" is the completion of an 
approved cosmetic art curriculum with a minimum 
grade of "C" or 70%. whichever is deemed as passing 
by the cosmetic arts of school. 

(6) "Esthetician School" is any cosmetic art school which 
teaches only the cosmetic arts of skin care. 

(7) "Esthetician Student" is a student in any cosmetic art 
school whose study is limited to the esthetician 
curriculum set forth in 21 NCAC 140 .0102. 



History Note: Aiitlv ;x G.S. 88B-2: 88B-f; 

Eff. February I. I97t): 

Amended Eff. June I. 1993: October I. 1991. May I. 1991: 

Januaiy 1. 1989: 

Temporarx Amendment Eff'. January 1. 1999; 

Amended Eff. August 1, 2000. 

.0103 OFFICE HOURS 

■ The office hours for the board are 8:00 a.m. to 5:00 p.m., 
Monday through Friday. The office is closed on state holidays. 

History Note: Authority G.S. 88B-4 
Eff. February 1. 1976: 
Amended Eff. January 1. 1989; 
Amended Eff August 1. 20U0. 

SUBCHAPTER 14C - CONTESTED CASES 

SECTION .0200 - REQUEST FOR A HEARING 

.0202 PREREQUISITES 

Before a hearing request is made, a person may attempt to 
resolve the problem with the Board informally by contacting the 
Chairman of the North Carolina State Board of Cosmetic Art 
Examiners, 1 20 1 - 1 1 Front St.. Raleigh, North Carolina 27609. 

Hi.story Note: Authority G.S. 88B-4: l50B-JI8(/i}; 

Eff. February I. 1976: 

Amended Eff. August 1. 20(10: July 1. 1993: Auiiiist I. 1988 

SUBCHAPTER 14F - RULES AND REGULATIONS 

GOVERNING THE LICENSING OF BEAUTY 

SALONS 

SECTION .0100 - LICENSING OF BEAUTY SALONS 



.0101 APPLICATION FOR SALON LICENSE 

Persons desiring to continue to operate or open a cosmetic art 
shop, or to reopen a cosmetic art shop which has been closed 
more than 90 days in the State of North Carolina shall make 
application to the North Carolina State Board of Cosmetic Art 
Examiners on an application form to be furnished by the Board. 

History Note: Authority G.S 888-14: 

Eff. February I. 1976: 

Amended Eff. August L 2000; April 1. 1988. 

.0105 NEWLY ESTABLISHED RESIDENTIAL 
SALONS 

(a) A cosmetic art shop shall be separate and apart from any 
building or room used for any other business or purpose, 
separated by a solid wall of at least seven feet in height and must 
have a separate outside entrance. 

(b) A newly established cosmetic art shop, shall be separate 
and apart from any building or room used for living, dining or 
sleeping and shall be separate and apart from any other room 
used for any other purpose by a solid wall of ceiling height, 
making separate and apart rooms used for a cosinetic art shop. 
All entrances to the cosmetic art shop shall be through solid, full 
length doors installed in solid walls of ceiling height. 

History Note: Authority G.S. 88B-4; 

Eff. Fehivan I. 1976; 

Amended Eff. August L 2000; May 1. 1998. 

SUBCHAPTER 14G - REQUIREMENTS FOR THE 
ESTABLISHMENT OF COSMETIC ART SCHOOLS 

SECTION .0100 - PERMANENT FILES 

.0103 SPACE REQUIREMENTS 

(a) The Cosmetic Art Board shall issue letters of approval 
only to cosmetology schools that have at least 2800 square feet 
of inside floor space for 20 stations or 4200 square feet of inside 
floor space for .^0 stations located within the same building. An 
additional 140 square feet of fioor space shall be required for 
each station above 20 stations, up to and including a total of 30 
stations. Thereafter, an additional 40 square feet shall be 
required for each station in excess of 30 stations. For purpose 
of this Rule, the day and night classes shall be counted as 
separate enrollments. A school may have a recitation room 
located in an adjacent building or another building within 500 
feet of the main cosmetology building. 

(b) Each cosmetology school must have no less than 20 
hairdressing stations, arranged to accommodate not less than 20 
students and arranged so thai the course of study and training 
cosmetology, as prescribed 21 NCAC 14J .0306, may be given. 
All stations must be numbered numerically. 

(c) Cosmetology schools must have a beginner department 
containing sufficient space to comfortably accommodate at least 
ten students and having at least 40 inches between mannequins. 

(d) The Board shall issue a letter of approval only to 



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manicurist schools that ha\e at least 1.000 square feet of inside 
floor space located within the same building. 

(e) Manicurist schools with 1 ,000 square feet of inside floor 
space shall enroll no more than 20 students at one time, and for 
each student enrolled in addition to 20 students, 50 square feet 
of inside floor space must be provided. 

(0 Manicurist schools must have 10 manicurist tables and 
chairs a minimum of two feet apart, side to side, arranged to 
comfortably accommodate ten students. 

(g) The Board shall issue a letter of approval only to 
esthetician schools that have at least 1,500 square feet of inside 
floor space located within the same building. 

(h) Esthetician schools with 1,500 square feet of inside floor 
space shall enroll no more than 20 students at one time, and for 
each student enrolled in addition to 20 students, 50 square feet 
of inside floor space must be provided. 

Histon Note: Aiithorin G.S. 88B-4; 

Eff. Fehruan- I. 1976: 

Amended Eff. April I. 1995: January L 1992: May 1, 1991: 

January I. I9H9. Max 1. 1988: 

Teniporan- Amendment Jaiiiiory I. 1999: 

Amended Eff. August L 2000. 

SUBCHAPTER 141 - OPERATIONS OF SCHOOLS OF 
COSMETIC ART 

SECTION .0100 - RECORD KEEPING 

.0109 SUMMARY OF COSMETIC ART 
EDUCATION 

(a) The manager of each cosmetic art school must compile, 
from the school's records, a summary of hours, live 
model/mannequin performance completions, date of enrollment, 
and last date of attendance. Upon graduation or within 30 days 
after the student's graduation date, the cosmetic art school must 
present to the student his or her examination application. 

(b) This examination application must be signed by the 
owner/director, a teacher, and the student and must have the seal 
of the school affixed. 

(c) The examination application must be prepared on a form 
furnished by the Board. 

History Note: Authority G.S. 88B-4: 88B-16: 

Eff. February I. 1976: 

Atnended Eff. August L 2000: Augu.st f 1998: May L 1991: 

January 1. 1989: April L 1988. 

SUBCHAPTER 14K - MANICURIST CURRICULUM 

SECTION .0100 - MANICURIST CURRICULUM 

.0102 COURSE OF STUDY 

(a) The .300 hours in classes required for licensure as a 
manicurist must include at least 260 hours of "classroom work" 
as described in Paragraph (c) and at least 40 hours of supervised 



"live model performances" as set forth in 21 NCAC I4K 
.()l07(a). 

(b) The following amount of classroom work is required tA 
the Board before taking the manicurist examination: % 

(1) 30 hours in manicuring, including trimming, filing, 
shaping, decorating, and ann and hand massage: 

(2) 140 hours in sculptured and other artificial nails; 

(3) 10 hours in pedicuring; 

(4) 20 hours in theory and salesmanship as it relates to 
manicuring; 

(5 ) 30 hours in the procedures and methods of sanitation, 
including the study of the Federal Environmental 
Protection Agency's disinfectant guidelines and the 
recommendations on the Material Safety Data Sheets 
prepared by the manufactures on all products used by 
the school's students in the live inodel performance 
set forth in 21 NCAC 14K .0107(a); 

(6) 30 hours in the study of bacteriology including 
communicable diseases and the requirements of The 
Pure Food and Drug Law for creams and lotions. 

(c) Classroom work shall include lectures on the subject as 
well as demonstrations, questions and answers on textbooks, 
written examinations, and in-class practice of procedures and 
methods but not live model performances as described by 21 
NCAC 14K .0107(b). 

Histoid Note: Authority G.S. 88B-I: S8B- If): 

Eff. Fehruan f 1976: ^ 

Amended Eff. December I. 1990: Jamiary I. 1989: April ^ 

1988: 

Temporaiy Amendment Eff. January 1. 1999: 

Amended Eff. Augu.st 1. 2000. 

.0107 LIVE MODEL PERFORMANCES 

(a) In completing the 40 hours of li\'e model performances 
required by 21 NCAC 14K .0102(b), all manicurist students 
shall complete the following minimum number of live model 
performancesduring the manicurist course under the supervision 
of a licensed cosmetic art teacher before taking the manicurist 
examination: 

(1) 15 manicures, including trimming, filing, and 
shaping; decorating; and arm and hand massage; 

(2) 100 applications or repair of sculptured or other 
artificial nails; and 

(3) 4 pedicures. 

(b) No manicurist student may perform any live model 
performances until he or she has completed 16 hours of 
classroom work, as defined in 21 NC.-\C 14K .0102(d). 
including at least four hours of bacteriology and four hours ol 
the procedures and methods of sanitation. 

(c) Live model performances are the rendering of the rciiui red 
service on a live person other than himself or herself They do 
not include performing the service on a mannequin. 



Histoty Note: Authority G.S. 8HB-4: S8B-I(): 
Eff. July 1. 1990: 



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Amended Ejf. April 1. 1991: December I. 1990: 
Temporary Amendment Ejf. Jamiary I, 1999: 
Amended Eff. Aimist 1, 2000. 



$ 



I 



SUBCHAPTER 14L - COSMETIC ART TEACHERS 

SECTION .0200 - TEACHER PROGRAM AND 
CURRICULUM 

.0216 TEACHER TRAINING CURRICULUM 

(a) To meet the apprcal of the Board, a cosmetologist 
teacher training course must consist of at least 800 hours of 
instruction in theory and practical application, divided as 
follows: 

( 1 ) One hundred fifty hours of instruction on methods of 
teaching and the laws governing cosmetology, to 
include the following topics: 

(A) instruction in teaching techniques; 

(B) instruction in preparing lesson plans; 

(C) instruction in preparing class lectures and 
presentations; 

(D) instruction in preparing examinations; and 

(E) G.S. 88B and the Rules of the Board. 

(2) Six hundred fifty hours of practice teaching, to 
include the following: 

(A) conducting theory classes from prepared lesson 
plans; 

(B) preparing and giving examinations; and 

(C) giving practical demonstrations, 
(h) To meet the approval of the Board, a manicurist teacher 

training course must consist of at least 320 hours of instruction 
in theory and practical application, divided as follows: 

( 1 ) One hundred and fifteen hours of instruction on 
methods of teaching and the laws governing 
manicuring, to include the following topics: 

(A) instruction in teaching techniques; 

(B) instruction in preparing lesson plans; 

(C) instruction in preparing class lectures and 
presentations; 

(D) instruction in preparing examinations; 

(E) instruction in chemical usage; and 

(F) G.S. 88B and the rules of the Board. 

(2) Two hundred and five hours of practice leaching, to 
include the following; 

( A ) conducting theory classes from prepared lesson 
plans; 

(B) preparing and giving examinations; and 

(C) giving practical demonstrations. 

(c) To meet the approval of the Board, a esthetician teacher 
training course must consist of at least 650 hours of instruction 
in theory and practical application, divided as follows; 

( 1 ) One hundred and twenty hours of instruction on 
methods of teaching and the laws governing skin care 
to include the following topics: 

(A) instruction in teaching techniques; 

(B) instruction in preparing lesson plans; 



> 



(C) instruction in preparing class lectures and 
presentations; 

(D) instruction in preparing examinations; 

(E) instruction in chemical usage; and 

(F) G.S. 88B and the rules of the Board. 

(2) Five hundred and thirty hours of practice teaching, to 
include the following: 

(A) conducting theory classes from prepared lesson 
plans; 

(B) preparing and giving examinations; and 

(C) giving practical demonstration. 

History Note: Authority G.S. 88B-4: 88B-11: 

Ejf. April 1. 1991: 

Amended Eff. March 2. 1992: 

Temporary Amendment Ejf. January 1, 1999: 

Amended Eff. August 1, 2000. 

SUBCHAPTER 14N - EXAMINATIONS 

SECTION .0100 - GENERAL PROVISIONS 

.0101 TIME AND PLACE OF EXAMINATIONS 

The Board shall announce the time and place for holding each 
examination at least ten work days prior to the date thereof. 

Histon- Note: Authority- G.S. 88B- 7( I): 88B-8( I ): 88B-18: 

88B-20(a): 88-4: 

Eff. June 1. 1992: 

Amended Eff. Augu st 1. 2000 

.0102 INITIAL APPLICATIONS AND FEES 

(a) All applications for examination must he on a form 
provided by the Board. 

(b) If special arrangements are required, the initial application 
or request for re-examination must include, an application for 
special arrangements pursuant to 21 NCAC 14N .0107. 

(c) The application must be tiled with the Board and 
accompanied by the applicable examination fee. If the 
application is not signed or is inadequately completed, or the 
proper supporting documentation is not enclosed, or the 
applicable fee is not paid, the application shall be deemed 
incomplete and returned. 

(d) If the examination fee is paid by check or money order, 
the check or money order shall be made payable to the "Board 
of Cosmetic Art Examiners". 

(e) If possible, the Board shall schedule candidates whose 
properly completed applications are received by the 10th of one 
month to take the examination during the following month. The 
Board shall assign the candidate to the location nearest to the 
candidate that is available for that month. 

Histon- Note: Authority G.S. 88B-1: 88B-7(1 ): 88B-8( 1 ): 

88B-18: 88B-20(a): 

Eff June 1. 1992: 

Amended Eff. Au.i;ust 1. 2000 



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.0103 GENERAL EXAMINATION INSTRUCTIONS 

(a) All candidates scheduled for an examination shall bring; 



(1) 

(2) 
(3) 

(4) 
(5) 



their social security card, 

a form of identification with a current picture. 

a kit containing all supplies necessary to perform all 

services required by the examination. 

a No. 2 pencil, and 

admission letter. 

(b) Candidates for the cosmetologist examination shall bring 
a mannequin that conforms with applicable requirements set 
forth in 21 NCAC 14N .0105. 

(c) Candidates for the cosmetologist, manicurist and 
esthetician teacher examination shall bring whatever supplies are 
suitable for presenting the theory lecture of their pre-assigned 
lecture topic and demonstrating the pre-assigned practical 
demonstration topic. 

(d) Candidates for the esthetician and esthetician teachers 
examination shall bring a live model. 

(e) Candidates shall not be accepted after roll call. 

(f) No candidate shall to bring books, electronic devices, 
calculators, papers, or reference materials of any kind into the 
testing room, except as provided in Paragraph (c) and (g) of this 
Rule. 

(g) Cosmetology teacher manicurist teacher and esthetician 
teacher candidates may use visual aids, prepared in advance, 
during the practical examination. During the lesson planning 
part of the examination, only a text book brought by that 
candidate may be used. 

Histon Note: Authority G.S. 88B-4: 88B-7: 88B-9: 88B-10: 

88B-n: 88B-I8: 

Eff. June I. 1992: 

Temponvy Amendment Eff. Janiiaiy 1. 1999: 

Amended Eff. August 1. 2000. 

.0104 LIVE MODEL REQUIREMENTS 

(a) If. a cosmetology teacher candidate has chosen to bring a 
live model for the examination; the model must; 

( 1 ) be at least 18 years old; 

(2) submit to all cosmetic art services required by the 
examination: and 

(.3) agree to a haircut of at least one to one and one-half 
inches during the examination. Hair must be of 
sufficient length to perform requirements after 
cutting. Prior to the examination, the model's hair 
must have already been shampooed, set and dried. 

(b) A model brought by a candidate for the manicurist or 
manicurist teacher examination, pursuant to 21 NCAC 14N 
.0103(d) shall; 

(1) be 18 years old. 

(2) submit to all cosmetic art services required by 
examination. 

(c) A model brought by a candidate for the esthetician or 
esthetician teachers examination pursuant to 21 NCAC 14N 
.0103(e) shall; 

(1) be 1 8 years old. 



;j 



(2) submit to all operations of esthetics. 

(d) Cosmetic art school or shop owners, cosmetologists or 
apprentice cosmetologists, manicurists, esthetician 
cosmetology, manicurist, or esthetician teachers, cosmetic 
shop operators, and present or former cosmetology or manicurist 
students may not sit as models. 

(e) No model may sit for more than one candidate at one 
exam. 

Histon Note: A uthorit}- G. S. 88B-4: 88B- 11:88B-1 8: 

Eff. June 1, 1992: 

Amended Eff. August 1. 1998: 

Temporaiy Amendment Eff. Januaiy I. 1999; 

Amended Eff. Auuu.ft L 2000. 

.0105 MANNEQUIN REQUIREMENTS 

If. pursuant to 21 NCAC 14N .0103(b) and (c). a candidate 
has chosen to bring a mannequin for the examination, the 
mannequin's hair shall be of sufficient length for the candidate 
to perform at least a one to one and one-half inch haircut. Hair 
shall be of sufficient length to perform rcquircinents after 
cutting. The candidate shall bring a holder for the mannequin, 

Histon- Note: Authority G. S. 88B-4: 88B- II: 

Eff. June I. 1992: 

Amended Eff. August L 2000: June I. 1993. 

.0110 PASSING GR.\DES FOR EX.\MINATION a 

Candidates shall make the following grades on both th" 
practical and theory sections of the examination; 

( 1 ) For licensure as a cosmetologist. 75 percent; 

(2) For licensure as an apprentice cosmetologist, 70 
percent; 

(3) for licensure as a cosmetology teacher . 85 percent: 

(4) For licensure as a manicurist teacher. 85 percent; 

(5) For licensure as a manicurist. 75 percent; 

(6) For licensure as a esthetician. 75 percent: and 

(7) For licensure as a esthetician teacher. 85 percent. 



88B-7(2): 88B-8(2); 
88B-ll(c)(3): 88B- 



HistoiyNote: Authority G.S. 88B-4 

8SB-9{2): 88B-10(2): 88B-1 1(b)(3): 

11(d)(3): 

Eff. June 1. 1992: 

Temporaiy Amendment Eff. Janucny 1. 1999: 

Amended Eff. August L 2000. 

.0112 REVIEW OF EXAMINATION 

(a) A candidate who has failed the practical section of an 
examination may upon written request receive a breakdown of 
the practical examination grades. A candidate ma\ not recei\e 
a breakdown of the theory section of an examination. 

(b) A candidate who has passed both sections of an 
examination at any level may not receive a breakdown of hi: 
examination trades. 



I 



Histon- Note: Authority- G.S. 88B-4: 88B-8(2l: 88B-I0(2): 



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88B-I8: 93B-8; 
Eff.Jiine I. 1992: 
^mended Eff. Aiisust 1, 2000: Janiian- I. 1996. 

SUBCHAPTER 140 - ESTHETICIAN CURRICULUM 

SECTION .0100 - ESTHETICIAN CURRICULUM 

.0102 COURSE OF STUDY 

The following course outline is required by the Board before 
taking the esthetician examination: 

( 1 ) orientation. 

(2) anatomy/physiology. 

(3) hygiene/sterilization/tlrst aid, 

(4) chemistry. 

(5) client consultation, 

(6) facial/body treatment (cleansing, massage, masks), 

(7) hair removal. 

(8) basic dermatology. 

(9) machines, electricity, apparatus, 

(10) aromatherapy. 

(11) nutrition. 

(12) business management. 

(13) make-up/color theory 

(14) professional ethics. 

History Note: Authority G.S. 88B- 4: 
Temporaiy Adoption Eff. January 1. 1999: 
"Eff Aiisust 1. 2000. 

.0103 EQUIPMENT AND INSTRUMENTS 

(a) An Esthetician school shall be equipped with the following 
minimum equipment: 

(1) 3 facial treatment chairs, treatment tables, or 
hydraulic treatment chairs, 

(2) 3 esthetician's stools, 

(3) I facial vaporizer, 

(4) 1 galvanic current apparatus, 
{5) 1 infra-red lamp, 

(6) 1 woods lamp. 

(7) 1 footed magnifying lamp or magnifying lamp that 
attaches to the wall. 

(8) 1 hair remo\'al wax system, 

(9) 1 thermal wax system. 

(10) 1 suction machine. 

(11) 1 exfoliation (brushes). 

(12) table for machines. 

(13) lavatory with hot and cold running water in the 
treatment area. 

(b) All equipment shall be maintained in a sanitary, safe 
operating order at all times. 

(c) The minimum requirement for a school of cosmetology 
desiring to include a department of esthetics in its training 
kuogram shall be at least one of each item specified in Paragraph 
(a). 

(d) Each esthetician student shall be supplied with: 
{ 1 ) cape. 



(2) 


spatulas. 


(3) 


astringents. 


(4) 


tweezers. 


(5) 


cotton pads. 


(6) 


make up supplies. 


(7) 


sponges. 


(8) 


all purpose cream 


(9) 


fumigant. 



History Note: Auflmrity G.S. 88B-4: 
Temporaiy Adoption Eff. Juiniary 1. 1999: 
Eff. Aimist I. 2000. 

.0106 LIVE MODEL PERFORMANCES 

(a) All esthetician students shall complete the following 
minimum number of live model pertbrmances during the 
esthetics course under the supervision of a licensed 
cosmetologist or esthetician teacher before taking the esthetician 
examination: 
(1) Facials: 

i) 40 Manual (skin analysis, cleansing, scientific 
manipulations, packs and masks). 
(B) 20 Electrical (the use of electrical modalitus, 
including dermal lights, and electrical 
apparatus for facials and skin care); 
50 Eyebrow arching and hair removal: 
40 Make-up (skin analysis, complete and corrective 
make-up). 

minimum of 60 hours of technical and practical 
instruction in application areas are required prior to conducting 
performances on the public. 



(2) 
(3) 

(b) A 



Histoiy Note: Authority G.S. 88B-4: 
Temporaiy Adoption Eff'. January 1, 1999: 
Eff. Aumst 1. 2000. 

SUBCHAPTER 14P - CIVIL PENALTY 

SECTION .0100 - CIVIL PENALTY 

.0101 SCHEDULE OF CIVIL PENALTIES 

The rules in this Subchapter establish the schedule of civil 
penalties required by G.S. 88B-2y(c). The amounts stated are the 
presumptive amounts which may be modified in accordance 
with G.S. 88B-29(b). Those violations that are P' offense 
correctable are identified with the word "warning" appended to 
it. If the offense is not corrected within the 30 day time allotted, 
the presumptive civil penalty in parenthesis shall apply. 

Histoiy Note: Authority G.S. 88B-4: 88B-29: 
Temporaiy Adoption Eff. January 1,1999: 
Eff. August I. 2000. 

.0102 QUALIFICATIONS FOR LICENSING 
TEACHERS 

The presumptive ci\il penalty for submitting false or 



14:5 



NORTH CAROLINA REGISTER 



September L 1999 



414 



APPROVED RULES 



fraudulcnl documentaticin on the application tor licensure as a 
teacher is: 

(1) 1^' offense $1,000.00 

(2) subsequent offense revocation of license and 

$1.0()().()() penalty 

History Note: Authority G.S. 88B-4: 88B-24: 88B-29; 
Temporary Adoption Eff. Jaiiuaiy 1, 1999: 
Eft: Auaiist I, 2000. 

.0103 TEMPORARY EMPLOYMENT PERMIT 

The presumptive civil penalty for practicing cosmetology, 
manicuring, or esthetics with an expired temporary employment 
permit is: 

(1) l"' offense warning ($100.00) 

(2) 2"" offense $2.S0.00 

(3) 3" offense $500.00 



Histoi-\- Note: Authority G.S. 88B-4: 88B-12: 88B-29: 
Teinporan Adoption Eff. Januaiy 1, 1999; 
Eff. August I. 2000. 

.0104 LICENSING OF COSMETIC ART SHOPS 

(a) The presumptive civil penalty for operating a cosmetic art 
shop without first fding an application for a cosmetic art shop 
license; 

(1) 1"' offense $100.00 

(2) 2" offense $200.00 
(,3) ,r\iffense $.300.00 

(b) The presumptive civil penalty for moving or changing 
location of an existing cosmetic art shop without first submitting 
the appropriate form and fee to the Board is: 

(1) 1^' offense $100.00 

(2) 2"Viffense $200.00 

(3) 3'' offense $300.00 



Teniporaiy Adoption Eff. January I. l^W: 
Eff. .4/>.t^H.s7 /, 20U(). 



.01 10 LICENSING OF BEAUTY SALONS 

(a) The presumptive civil penalty for use of a cosmetic art 
shop as living, dining, or sleeping quarters is: 

(1) r' offense warning ($30.00). 



« 



(2) 
(3) 



Tnd 



offense 



3'" offense 



$100.00. 
$200.00. 



(b) The presumptive civil penalty for failure to provide a 
separate entrance into the cosmetic art shop is: 

(1) r' offense warning (SI OO.OO). 

(2) 2"' offense $200.00. 

(3) 3^'' offense $400.00. 

(c) The presumptive civil penally for re-opening a cosmetic art 
shop which has been closed for more than 90 days without 
making application to the Board for a new license: 

r' offense $100.00 

2"' offense $200.00 



3'' offense 



$300.00 



Hi.stoiy Note: Authority G.S. 88B-4: 88B-f4: 8SB-29: 
Teniporaiy Adoption Eff. Januaiy I, 1999: 
Eff. Ausust 1. 2000. 

.0115 SANITARY RATINGS 

The presumptive civil penalty for a school failure to display 
an inspection grade card is: 

( 1 ) r' offense warning (S?0.0O) 

(2) 2"' offense $100.00 



% 



(3) 3'''oflense 



$200.00 



Histon- Note: Autlwrit\- G.S. 88B-4: 88B-29: 
Teniporaiy Adoption Eff. Janiian' f. f999: 
Eff. AuRust /. 2000. 



History Note: Authority G.S. 88B-4: 



I 



475 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



RULES REVIEW COMMISSION 



1 his Section contains the agenda for the next meeting of the Rules Review Commission on Thursday. September 16. 1999. 
10:00 a.m. . at 1 307 Glenwood Ave., Assembly Room, Raleigh, NC. Anyone wishing to submit written comment on any rule 
before the Commission should submit those comments to the RRC staff, the agency, and the individual Commissioners by 
Monday. September L\ 1999, at 5:00 p.m. Specific instructions and addresses may be obtained from the Rules Review 
Commission at 919-733-2721. Anyone wishing to address the Commission should notify the RRC staff and the agency at 
least 24 hours prior to the meeting. 



RULES REVIEW COMMISSION MEMBERS 



Appointed by Senate 

Teresa L. Smallwood, Vice Chairman 
John Arrowood 

Laura Devan 

Jim Funderburke 

David Twiddy 



Appointed by House 

Paul Powell. Chairman 

Anita White, 2"'' Vice Chairman 

Mark Garside 

Steve Rader 

George Robinson 



RULES REVIEW COMMISSION MEETING DATES 



September 16. 1999 
October 21, 1999 



November 1 8. 1 999 
December 16. 1999 



LOG OF FILINGS 
RULES SUBMITTED: JULY 20, 1999 THROUGH AUGUST 20, 1999 



AGENCY/DIVISION 



RULE NAME 



RULE 



DEPARTMENT OF INSURANCE 

Suitability 

DEPARTMENT OF LABOR 



NCAC 



102.S 



Scope 

Definitions 

Training and Education 

Resp./Symptons Indicating/Dev./MSD 

Medical Management 

Actual Compliance or Safe Harbor 

DENR/SEDIMENTATION CONTROL COMMISSION 

Procedures: Notices 

EDUCATION, STATE BOARD OF 

Graduation Requirements 

Grade Level Proficiency 

Definitions 

Student Accountability Standards 

State Graduation Requirements 

I Review Procedures 

Local Accountability Procedures 
Students with Disabilities 
Students/Limited English Proficiency 

STATE BOARDS/NC BOARD OF REGISTRATION FOR FORESTERS 



13 NCAC 7F .0601 
1 3 NCAC 7F .0602 
1 3 NCAC 7F .0603 
1 3 NCAC 7F .0604 
1 3 NCAC 7F .0605 
1 3 NCAC 7F .0606 



15 NCAC 4C .0107 



ACTION 



Amend 



Adopt 
Adopt 
Adopt 
Adopt 
Adopt 
Adopt 



Amend 



1 6 NCAC 6D 


.0103 


Repeal 


16 NCAC 6D 


.0304 


Repeal 


1 6 NCAC 6D 


.0501 


Adopt 


16 NCAC 6D 


.0502 


Adopt 


1 6 NCAC 6D 


.0503 


Adopt 


16 NCAC 6D 


.0504 


Adopt 


16 NCAC 6D 


.0505 


.4dopt 


16 NCAC 6D 


.0506 


Adopt 


16 NCAC 6D 


.0507 


Adopt 



14:5 



NORTH CAROLINA REGISTER 



September 1, 1999 



416 



RVLES REVIEW COMMISSION 



Purpose of Program 

Qualifications for Registration 

Examinations 

References 

Registration Fees 

Reciprocity 

Certification of Consulting Foresters 

Handling of Complaints 

Continuing Education 

NC HOUSING FINANCE AGENCY 

Persons and Families of Moderate Income 



21 NCAC20.0101 


Amend 


21 NCAC2O.01O3 


Amend 


21 NCAC20.0104 


Amend 


21 NCAC20.01O5 


Amend 


21 NCAC20.0106 


Amend 


21NCAC20.0117 


Amend 


21 NCAC20.0120 


Amend 


21 NCAC20.0122 


Amend 


21 NCAC20.0123 


Adopt 


24NCAC 1H.0103 


Amend 



< 



RULES REVIEW COMMISSION 

August 19. 1999 
MINUTES 

The Rules Review Commission met on August 19, 1999. in the Assembly Room of the Methodist Building. 1307Glenwood Avenue. 
Raleigh. North Carolina. Commissioners in attendance were Chairman Paul Powell, Teresa Smallwood, Jennie J. Hayman. Walter 
Futch. Jim Funderburk. John Arrowood. Laura Devan. R. Palmer Sugg, David R. Twiddy. and George Robinson. 

Staff members present were: Joseph J. DeLuca. Staff Director; Bobby Bryan. Rules Review Specialist: and Sandy Webster. 

The following people attended: 



Harry Wilson 
Dedra Alston 
Dee Williams 
Emily Lee 
Mell Nevils 
Laura Crumpler 
Jennie Wilhelm Mau 
Sherri Knight 
Arthur Mewberry 
Jessica Gill 
David A. Hance 
Greg Bright 
Linda Suggs 
Charles Johnson 
Mary Johnson 
Mary Thompson 

APPROVAL OF MINUTES 



State Board of Education 

DENR 

State Board of Cosmetic Art Examiners 

TRANSPORTATION/Division of Motor Vehicles 

DENRyOLR/LQS 

Attorney General 

Attorney General 

DENR/GW 

DENR/DWQ/Groundwater 

DENR/Coastal Resources Commission ■ 

DENRyDWQ/Groundwater 

DENRAVell Contractors 

NCASA 

Commerce/Finance 

Commerce/Finance 

DENR/Coastal Resources Commission 



« 



The meeting was called to order at 10:01 a.m. with Chairman Powell presiding. He asked for any discussion, comments, or 
corrections concerning the minutes of the July 15, 1999 meeting. There being none, the minutes were approved. 

SWEARING IN OF NEW COMMISSIONERS 

Staff Attorney Robert A. Bryan. Jr. swore in new Commissioners Jennie J. Hayman and Walter Futch. 
FOLLOW-UP MATTERS 



2 NCAC 20B .0104: AGRICULTURE/Board of Agriculture - The rewritten rule submitted by the agency was approved by the 
Commission. 



( 



417 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



RULES REVIEW COMMISSION 



2 NCAC 43L .0309: AGRICULTURE/Board of Agriculture - The rewritten rule submitted by the agency was approved by the 
Commission. 

ftm NCAC 54 .0103 and .0105: AGRICULTURE/Agriculture and Consumer Services - These rules were returned to the agency. 

12 NCAC 9A .0103: JUSTICE/Criminal Justice Education & Training Standards Commission - This Commission will meet on 
August 27, 1999 and the agency will respond after their Commission meets. 

12 NCAC 9B .0107, .0113, .0201 . .0202, .0203, .0204, .0205. .0206, .0226, .0227, .0228, .0232, .0233 and .0305: JUSTICE/Criminal 
Justice Education & Training Standards Commission - The Commission will meet on August 27, 1999 and the agency will respond 
after Iheir Commission meets. 

1 2 NCAC 9C .02 1 1 , .02 1 2. and .02 1 3: JUSTICE/Criminal Justice Education & Training Standards Commission - This Commission 
will meet on August 27, 1999 and the agency will respond after the Commission meets. 

12 NCAC lOB .0103: JUSTICE/Sheriffs" Education & Training Standards - This Commission will meet on September 16, 1999 
and the agency will respond after the Commission meets. 

I5ANCAC 7H .0309, .1805, and .2105: DENR/Coastal Resources Commission -The Commission approved the rewritten rules for 
.0309 and .2105 submitted by the agency. They continued the objection to .1805 due to lack of statutory authority. In (f), the added 
provision allowing the division to approve work from May 1 through November 15 is a waiver provision without specific guidelines 
in violation of G.S. 150B-19(6). 

16 NCAC 6C .0501: STATE BOARD OF EDUCATION - The rewritten rule submitted by the agency was approved by the 
Commission. A motion to rescind the action taken last month to return 16 NCAC 6C .0304 to the agency for failure to comply with 
the rulemaking provisions of the APA failed on a voice vote. 

19A NCAC 31 .0.307, .0402, and .0804: TRANSPORTATION/Di vision of Motor Vehicles - The rewritten rules subinitted by the 
ipgency were approved by the Commission. 

21 NCAC 141 .0104 and .0107: State Board ofCosmetic Art Examiners -The rewritten rules submitted by the agency were approved 
by the Commission because they had obtained the necessary authority. 

21 NCAC 14J .0208 and .0501 -StateBoardofCosmetic Art Examiners -The rewritten rules submitted by the agency were approved 
by the Commission. 

21 NCAC 14L .0101 - State Board ofCosmetic Art Examiners - The rewritten rule submitted by the agency was approved by the 
Commission. 

21 NCAC 14N .01 13 - State Board ofCosmetic Art Examiners - The rewritten rule submitted by the agency was approved by the 
Commission. 

21 NCAC 140 .0101 and .0104 - State Board of Cosmetic Art Examiners - The rewritten rules submitted by the agency were 
approved by the Commission. 

21 NCAC 14P.0105,. 01 11.. 01 12, .01 13, .01 14, and .01 16 -State Board of Cosmetic Art Examiners -The rewritten rules submitted 
by the agency were approved by the Commission. 

LOG OF FILINGS 

Chairman Powell presided over the review of the log and all rules were unanimously approved with the following exceptions: 

4 NCAC 1 1 Rules - COMMERCE/Commerce Finance Center - These rules were returned to the agency for failure to comply with 
the notice provisions of the Administrative Procedures Act. The Notice of Text provides that the comment period would be open 
Ijhrough May 17, 1999. The Submission Form indicates this rule was adopted by the agency on May 6, 1999, prior to the close of 
"he comment period. In addition the notice stales that the rules do not have a substantial economic impact of $5,000,000 in a 1 2 month 
period, but the fiscal note does show a total economic impact of $10,420,000 in fiscal year 1999-2000. This requires a 60 day 
comment period, rather than the 30 day period provided for in the notice. (G.S. 150B-2I .2(f)). Therefore the agency needs to 

/•/.•5 NORTH CAROLINA REGISTER September I, 1999 418 



RULES REVIEW COMMISSION 



republish all these rules with the proper ceimment period, observe the eomment period, and then adopt the rules. 

15A NCAC 27 .01 10 (subsequently renumbered as .0101)- DENRAVell Contractors Certification Commission- The Commissioi^ 
objected to this rule due to lack of statutory authority. In (i ) there are no standards specified for approving organizational or individual 
sponsors of continuing education courses. Paragraphs (j) and (k) either redefine or repeat the contents of statutor) definitions atG.S. 
87-98.2. 

15A NCAC 27 .0201 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due lo lack of 
statutory authority. There is no authority cited for not charging well contractors who work for municipal governments the exam or 
licensing fee. There is no indication given that it was the intent of the general assembly to make that exemption. 

1 5 A NCAC 27 .0301 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to ambiguity. 
In (e)(2) it is unclear what constitutes a "business related to well contractor activities." It is also unclear what constitutes 
"satisfactory. . .equivalent experience." In (e )( 1) - (3) various tests to establish satisfactory experience are set out. Item (4 ) states that 
insteadof (D- (3) a person may submit evidence of equivalent experience. It seems that a person may show other ways of proving 
experience but it is unclear what the equivalence is. After all what is the equivalent experience to completing 25 wells in 24 months 
or "working in a well contractor activity for 24 months" that is not working in this activity? It is possible that the board may accept 
a combination of experience and education or education alone as an equivalent to the work experience, but thai is not what the rule 
says or implies. 

15A NCAC 27 .0410 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to lack of 
statutory authority. In (a) the Commission may allow an exam to be administered orally, rather than in writing for "exceptional" 
circumstances. This is a waiver provision. The Commission may not grant such a waiver without specific guidelines the agency shall 
follow in granting or denying the waiver. 

15A NCAC 27 .0420 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to ambiguity. 
In (2)(a) it is unclear what constitutes "a sufficient number of applicants" to justify scheduling an examination. In i2)(b) it is unclear 
what constitutes "exceptional circumstances" or the standards the Commission shall use in deciding whclher to grant ov deny the 
application. A 

15A NCAC 27 .0430 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to lack of 
statutory authority. Rules relating to internal agency procedures are not to be adopted as rules. G.S. 143B-10(j)(3). 

15A NCAC 27 .0701 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to lack of 
statutory authority and necessity. This rule simply repeats the provisions of G.S. 87-98.5. is unnecessarv. and violates G.S. 15()B- 
19(4). 

1 5 A NCAC 27 .08 10 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to ambiguity. 
In ( 1 )- (4) of this rule, especially when taken with .0820, it is unclear what constitutes "course completion." "course credit." and what 
PDH credit the licensee will earn. 

1 5A NCAC 27 .0820 - DENRAVell Contractors Certification Commission - The Commission objected to this rule due to ambiguity. 
In ( 1 )-(4)of this rule, especially when taken with .0810, it is unclear what constitutes "course completion." "course credit." and what 
PDH credit the licensee will earn. In (5) it is unclear how the agency will determine that a course or activity contains "a clear purpose 
and objective and resultjs] in the maintenance, improvement, or expansion of skills..." "without scrutiny of individual course content." 

15A NCAC 27 .0840 - DENR/Well Contractors Certification Commission - The Commission objected to this rule due to lack of 
statutory authority and ambiguity. There is no authority cited to grant an exemption from the statutory continuing education 
requirement. While an agency has the authority to grant exemptions to its own rules, it has no authority to exempt persons from the 
statutory requirements, at least not unless such authority is specifically granted by the legislature. E\'en if there is authority' for this 
rule, it is unclear what constitutes "physical disability, illness, or other extenuating circumstances..." in (3). The logical question that 
needs to be answered is what sort of disability, illness, or circumstances would render a person capable ol perfomiing satisfactorily 
as a well contractor but not able to obtain or needful of obtaining continuing education hours. It is also uncicai what standards the 
board shall use in determinini: whether to grant the exemption. 

I 

21 NCAC 12 .0504 - NC Licensing Board tor General Contractors - This rule was withdrawn by the agencx. 



419 NORTH CAROLINA REGISTER September /, 7999 14:5 



RULES REVIEW COMMISSION 



COMMISSION PROCEDURES AND OTHER MATTERS 

J Mr. DeLuca announced that election of officers would take place next month. The Commission voted to go into Executive Session 
|o consider the lawsuit and hear from its attorneys. The Commission reconvened after Executive Session and voted to adjourn at 
12:25 p.m. 

The next meeting will be on September 16, 1999. 

Respectfully submitted. 
Sandy Webster 



i 



14:5 NORTH CAROLINA REGISTER September I, 1999 420 



CONTESTED CASE DECISIONS 



1 his Section contains the full text of some of the more significant Administrative Law Judge decisions cdoiif; with an index 
to all recent contested cases decisions which are filed under North Carolina i Administrative Procedure Act. Copies of the 
decisions listed in the index and not published are available upon request for a minimal charge by contacting the Office of 
Administrative Hearings. (919) 733-2698. Also, the Contested Case Decisions are available on the Internet at the followuig 
address: http://www.state.nc.us/OAH/hearings/decision/caseiiidex.htm. 



I 



OFFICE OF ADMINISTRATIVE HEARINGS 

Chief Administrative Law Judge 
JULIAN MANN, III 

Senior Administrative Law Judge 
FRED G. MORRISON JR. 

ADMINISTRA TIVE LA W JUDGES 



Sammie Chess Jr. 
Beecher R. Gray 
Melissa Owens 



Meg .Scott Phipps 

Robert Roosevelt Reilly Jr. 

Beryl E. Wade 



AGENCY 

ADMINISTRATION 

Bnlthaven. inc. v. Department of Adnunislralion 

and 
Pnva-Trends. Inc. 
Laidlaw Transit Svcs. Inc. v. Kane G Dorset:. Sec'y/Dept/Adniinisiration 

OFFICE OF ADMINISTRATIVE HEARINGS 

Ted Murrell. Zam. Inc. v. Office of Administrative Hearings 
Samuel Lee Ferguson v. Office of Administrative Heanngs 

AGRICULTURE 

Archie McL.ean v Department of Agnculture 

ALCOHOLIC BEVERAGE CONTROL COMMISSION 

Alcoholic Beverage Control Commission v. Keyland. Inc.. T/A Cloud 9 
Alcoholic Beverage Control Commissionv, Food Lion. Inc.. Store#1.^5l 
Alcoholic Beverage Control Commission v. Beech Mountain Resort, Inc. 
Alcoholic Beverage Control Commission v. Jaeson Nyuns Kim 
Delores Ann Holley v. Alcoholic Beverage Control Commission 

CRIME CONTROL AND PUBLIC SAFETY 

Paul Richard Mull v. Crime Victims Compensation Commission 
Bohby Mills v. Crime Victims Compensation Commission 
William Samuel McCraw v. Crime Vicnms Compensation Commission 
Anson D. Looney v. Cnme Victims Compensation Commission 
Elvin Williams, Jr. v. Cnme Victims Compensation Commission 
Michael Anthony Powell v. Crime Victims Compensation Commission 
Mary Elizabeth Peoples Hogan v. Cnme Victims Compensation Comm. 
Annabell B. McCormick v. Cnme Victims Compensation Commission 

ENVIRONMENT AND NATURAL RESOURCES 

R.J. Reynolds Tobacco Co. v. Dept. of Environment & Natural Resources 
Willie Setzer v. Department of Environment & Natural Resources 
Charles H. Jordan v. Brunswick County Health Department 
Roadway Express v Department of Environment and Natural Resources 



CASE 




NUMBER 


AL,J 


98DOA081I 


Chess 


99DOA0102 


Morrison 


99 OAH 0()65 


Chess 


99OAH0718 


Chess 


98 DAG 1770 


Reilly 


98 ABC 1099 


Overby 


98 ABC 1270 


Grav 


99 ABC 0287 


Reilly 


99 ABC 0407 


Momson 


99 ABC 0876 


Gray 


98 CPS 0.^42 


Chess 


98CPS 1412 


Wade 


98 CPS 1626 


Morrison 


99 CPS 0096 


Morrison 


99 CPS 01 18 


Owens 


99 CPS 0426 


Reilly 


99 CPS 0.S04 


Reilly 


99 CPS 0564 


Phipps 


98EHR l,SI5 


Wade 


99EHR0I66 


Chess 


99EHR020I 


Momson 


99 EH R 0745 


Momson 



DATE OF 
DECISION 



06/10/99 



06/11/99 



07/14/99 
07/16/99 



07/12/99 



01/17/99 
O.Wl/99 
08/1 1/99 
07/09/99 
08/10/99 



07/26/99 
08/06/99 
06/09/99 
0.5/25/99 
O8/0.V99 
O8/0.V99 
07/29/99 
08/04/99 



06/04/99 
06/28/99 
06/28/99 
07/27/99 



PUBLISHED DECISION 
REGISTER CI I VTION 



< 



14:02 NCR 115 



14:04 NCR .^49 



14:04 NCR .147 



1402 NCR no 



« 



■421 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



CONTESTED CASE DECISIONS 



AGENCY 

L Division of Air Quality 

flenance W, Bache, Pres.. Terhane Group. Inc. v. DENR. Di\/Air Qualily 
,\V11I Airhome Corps & Fort Bragg, Dept, of the Army. USA \ . 

En\ironment and Natural Resources. Div. of Air Quality 
J D Owen v. Environment and Natural Resources. Div of Air Oualrty 

Environmental Management 

Allen Raynor \', hn\'ironmenlal Management Commission 

Division of Land Resources 

Buel B. Barker, .Ir and Huhbard Realty of Winston-Salem. a NC Corp.. 
jointly and severally \ Dept, of Environment and Natural Resources, 
Div. of Land Resources 



CASE 




DATE OF 


NUMBER 


AL.I 


DECISION 


98EHR 1790 


Mann 


06/2.1/99 


99 EH R 028.^ 


Wade 


08/11/99 


99EHR0642 


Mann 


08/10/99 


99EHR0I27 


Gray 


07/nm 


98EHR \AS1 


Momson 


06/09/99 



PUBLISHED DECISION 
REGISTER CITATION 



Division of Water Quality 

York Oil Company v. DENR. Division of Water Quality 

J Todd Yates and Teresa B, Yates v. DENR. Div. of Water Quality 

BOARD OF GEOLOGISTS 

Aiidrevs M Raring. Ph.D \, Board for the Licensing of Geologists 

HEALTH AND HUMAN SERVICES 

Ernest Ch ' Ahsher and Dianna B. Absher v. Health & Human Resources 

Andrew ^ainey v. Office of the Chief Medical Examinei 

J. P. Lynch v. Department of Health & Human Services 

New Hope Living Centers. Enc D. Lewis v. Health & Human Services 

Frank McKoy v. Department of Health & Human Services 

loan Mane McDaniel v. Department of Health & Human Services 

Lonnie Herring v. Department of Health & Human Ser\'ices 

Robert H Riley \. Office of the Governor. OtTice of Citizen Services 

Division of Child Development 

k Shaw Speaks Child Dev. Ctr. v. Health & Human Svcs.. Child Dev. 

fLachelle L. Parsons v. Health & Human Svcs. Div. of Child Dev . 
In The Beginning. Inc. v. Health & Human Svcs.. Div. of Ciild Dev 
Dulaiown Outreach Center. Inc. v Health & Human Svcs.. Child Dev 
Michele Denoff \ Health & Human Services. Di\ . of Child Dev, 

Division of Facility Services 

Kelly M. Poole \'. Health & Human Services. Div. of Facility Services 
Nomia Faye Lewis v. Health & Human Svcs.. Div. of Facility Services 
Delia C. Jones v. Health cS: Human Services. Div, of Facility Services 
Effie Ruth Smith v. Health & Human Svcs,, Div, of Facility Services 
Dons Laviner Moser v. Health & Human Services. Div. of Facility Svcs. 
Norma Faye Lewis v. Health & Human Svcs.. Div. of Facility Services 
Carolyn Grant V. Health & Human Services. Div. of Facility Services 
Manon Moser Thompson \ . Health & Human Svcs.. Facility Services 
Rose Mane Hadley v. Health A; Human Svcs.. Div. of Facility Services 
Sarah Frances Alford v. Health & Human Svcs.. Div. of Facility Svcs. 
\lvin L. Phynon Jr \ Health i; Human Svcs.. Dept of Facility 
Barbara Rhue\. DF.S. 
Barbara Rhue v. DF.S 
Esther Nieves \. Health & Human Services. Div. of Facility Services 

Division of .Medical Assistance 

Companion Health Care. Inc. v, Div, of Medical Assistance. DHR 



Division of Menial Health, Developmental Disabilities and Substance Abuse Services 

S.S. by her parents and next friends. D.S. & A.S. v. DMH/DD'SAS 



Division of Social Senices 

Koben H Riley \ Iredell County DSS 

Robert H, Riley v. Health & Human Svcs.. Div. of Social Services 
loanna Pnce v. Caldwell County Social Services 
k\ eronica Owens \ Dept of Social Services Union Countv 



97EHR 1026 


Phipps 


07/26/99 


98 EHR 1456 


Wade 


06/22/99 


99BOG0L50 


Mann 


06/16/99 


98 DHR 1622 


Reilly 


06/17/99 


98 DHR 1761 


Owens 


05/12/99 


99 DHR 01 11 


Reilly 


0.5/25/99 


99 DHR 0170 


Owens 


05/25/99 


99 DHR 0226 


Wade 


07/06/99 


99 DHR 0.10.5 


Reilly 


08/05/99 


99DHR0.\50 


Reilly 


06/0.V99 


99DHR0.V56 


Wade 


07/21/99 


99 DHR 0042 


Gray 


07/22/99 


99DHR044.S 


Reilly 


07/19/99 


99DHR0.'i75 


Mann 


07/19/99 


99 DHR 0688 


Owens 


07/21/99 


99DHR069.S 


Owens 


08/05/99 


97 DHR 0629 


Chess 


06/14/99 


98 DHR 1274 ■' 


Phipps 


07/02/99 


98 DHR 1680 


Gray 


06/09/99 


98 DHR 1774 


Chess 


07/14/99 


99 DHR 0074 


Wade 


08/06/99 


99 DHR 0144*' 


Phipps 


07/02/99 


99 DHR 0145 


Mann 


06/11/99 


99 DHR 02 16 


Gray 


08/1.W9 


99 DHR 02 18 


Wade 


08/06/99 


99 DHR 0220 


Phipps 


06/08/99 


99DHR02.W 


Mann 


07/07/99 


99 DHR 0401*' 


Wade 


07/.S0/99 


99 DHR 04 14*' 


Wade 


07/.10/99 


99 DHR 0766 


Phipps 


07/21/99 


99 DHR 0762 


Owens 


07/29/99 


Services 






99 DHR 05.^8 


Gray 


08/02/99 


99 DHR 0.154 


Wade 


07/21/99 


99 DHR 0.155 


Wade 


07/21/99 


99 DHR 0520 


Momson 


06/10/99 


99 MIS 0677 


Mann 


08/ 1 7/99 



14:04 NCR M? 



14 01 NCR 69 



Consolidated Cases. 



14:5 



NORTH CAROLINA REGISTER 



September /, 1999 



422 

mm 



CONTESTED CASE DECISIONS 



AGENCY 

ChilJ Support Enfhrcemenl Seclion 
Lindy Teachout v. Department of Health & Human SeiA-ices 
Thomas Ashley Stewan II v. Department of Health & Human Sei^ices 
Richard Arnold Colhns v- Jones County DSS 
Kenneth Wayne Adair v. Department of Human Resources 
Hun G, Stokes v. Department of Health & Human Services 
G-S. Hall V. Depanment of Health & Human Services 
Kenneth A- McCrone v. Department of Human Resources 
Donald Edward Law II v. Department of Human Resources 
Robert M. Chandler Jr. v. Department of Health & Human Services 
Grady L. Chosewood v. Depanment of Health & Human Services 
Fulton Allen Tillman v. Department of Health & Human Services 
Nathaniel Alston v. Department of Health & Human Services 
Bret Burtrum v. Department of Health & Human Services 
Cedric A. Hurst v. Department of Human Resources 
Dane Wesley Ware v. Department of Health & Human Services 
Oscar William Willoughby Sr. v, Dept, of Health & Human Services 
Kelvin E. Townsend v. Department of Health & Human Services 
Billy J. Young v. Depanment of Health & Human Services 
Adelheide J. Cooper v. Depanment of Health & Human Services 
Beverly K. Thompson v. Department of Health & Human Services 
Michael L, Timmer V, Department of Health & Human SeA'ices 
Elizabeth F. West v. Department of Health & Human Services 
Troy Gibson v. Department of Health & Human Services 
Roy D. Washington v. Department of Health & Human Services 
Calvin D. Alston v. Depanment of Health & Human Services 
Marquel Simmons v, Depanment of Health & Human Services 
Gerald Scott Saucier v. Department of Health & Human Services 
Lawrence Gordon Soles v. Department of Health & Human Services 
Mohamed Moustafa v. Department of Health & Human Services 
Charlie James White v. Department of Health & Human Services 
Lane Bolton v. Department of Health & Human Services 
Earl C. Jones. Sr. v. Department of Health & Human Services 
Kathryn P, Fagan \, Department of Health & Human Services 
Deborah Seegars v. Department of Health & Human Services 
Lillian Anne Danoch v. Department of Health & Human Services 



CASE 




DATE OF 


PUBLISHED DECISION 


NUMBER 


ALJ 


DECISION 


REGISTER (TfATION 


98 CRA 0727 


Reilly 


06/24/99 




99CRA0628 


Reilly 


06/14/99 




96CSE18I0 


Reilly 


06/28/99 




98CSE02:9 


Momson 


06/30/99 




98 CSE 0898 


Gray 


07/23/99 




98CSE 1392 


Reilly 


06/24/99 




98 CSE 1415 


Gray 


08/04/99 




98 CSE 1586 


Momson 


06/25/99 




98 CSE 1789 


Phipps 


05/27/99 




99 CSE 0301 


Mann 


07/01/99 




99 CSE 03 11 


Reilly 


06/30/99 




99 CSE 0317 


Mann 


07/01/99 




99 CSE 03 18 


Wade 


07/14/99 




99 CSE 0330 


Chess 


08/10/99 




99 CSE 0359 


Gray 


06/28/99 




99 CSE 0371 


Momson 


06/28/99 




99 CSE 0373 


Phipps 


07/12/99 




99 CSE 0374 


Reilly 


06/14/99 




99 CSE 0428 


Phipps 


07/19/99 




99 CSE 0435 


Reilly 


06/14/99 




99 CSE 0437 


Wade 


06/08/99 




99 CSE 045 1 


Momson 


05/25/99 




99 CSE 0462 


Owens 


07/19/99 




99 CSE 0481 


Reilly 


06/25/99 




99 CSE 0539 


Owens 


08/10/99 




99 CSE 0547 


Wade 


08/06/99 




99 CSE 0576 


Mann 


06/09/99 




99 CSE 0581 


Momson 


06/09/99 




99 CSE 0582 


Owens 


08/05/99 




99 CSE 0690 


Momson 


07/20/99 




99 CSE 0735 


Phipps 


08/06/99 




99 CSE 0801 


Gray 


08/10/99 




98 DCS 1769 


Momson 


06/25/99 




99 DCS 0505 


Phipps 


06/30/99 




99 DCS 0555 


Gray 


07/06/99 





» 



I 



JUSTICE 

Alarm Systems Licensing Board 

Terry Allen Bnckey v. Alarm Systems Licensing Board 
Travis Enc Reardon v. Alarm Systems Licensing Board 
Bnan Anthony Bartimac v. Alarm Systems Licensing Board 
Paul Luke Walczak v. Alarm Systems Licensing Board 
Melvin T. Lohr v. Alarm Systems Licensing Board 
Bradford D. Penny v. Alarm Systems Licensing Board 
Benny L. Shaw v. Alarm Systems Licensing Board 
Donald Eugene Boger v. Alarm Systems Licensing Board 
Kajur Washburn v. Alarm Systems Licensing Board 

Education and Training Standards Division 

Rock Steven Edwards v. Criminal JusUce Ed. & Training Stds. Comm 
Anthony Scott Hughes v. Shenffs' Ed, & Training Standards Comm. 
Hal Pilgreen v. Cnminal Justice Ed. & Training Stds. Comm. 
Emma J. Kiser v Sheriffs' Ed. & Training Standards Comm. 
Keith Allen Noms v. Sheriffs' Ed, & Training Standards Comm. 
Sherry Davis Kenney v. Cnminal Justice Ed, & Training Stds. Comm, 
Russell Lee Yelverton v. Cnminal Jusuce Ed, & Training Stds. Comm. 

Private Protective Services Board 

Thomas E. Mewbom v. Private Protective Services Board 
Michael Lynn Aner v. Pnvate Protechve Services Board 
Jeffrey S, Moore v. Pnvate Protective Services Board 
Bonnie Marie Keller v. Private Protective Services Board 
Shawn E. Alexander v. Private Protective Ser\ices Board 
Ronald E. Sulloway v, Pnvate Protective Services Board 
Raymond Solomon v. Pnvate Protective Ser\ices Board 
Charles E, Evans. Jr v. Private Protective Services Board 
Wiiham E. Ellis. Sr, v. Pnvate Protective Services Board 



99 DOJ 0097 


Wade 


05/21/99 




99 DOJ 0446 


Phipps 


07/28/99 




99 DOJ 0487 


Momson 


05/25/99 




99 DOJ 0489 


Owens 


08/03/99 




99 DOJ 0490 


Momson 


05/24/99 




99 DOJ 0522 


Momson 


06/08/99 




99 DOJ 0523 


Momson 


06/08/99 




99 DOJ 0715 


Owens 


07/29/99 




99 DOJ 0716 


Owens 


07/29/99 




98 DOJ 0906 


Chess 


05/13/99 




98 DOJ 1.5.30 


Chess 


05/12/99 




98 DOJ 1775 


Chess 


06/09/99 




98 DOJ 1793 


Gray 


06/07/99 




99 DOJ 0045 


Mann 


07/29/99 


4:04 NCR 35 1 


99 DOJ 0067 


Wade 


06/08/99 




99 DOJ 0131 


Phipps 


08/1 1/99 




99 DOJ 0101 


Owens 


07/30/99 




99 DOJ 0262 


Wade 


05/25/99 




99 DOJ 0488 


Momson 


05/24/99 




99 DOJ 0491 


Momson 


05/24/99 




99 DOJ 0492 


Owens 


07/19/99 




99 DOJ 0493 


Momson 


05/24/99 




99 DOJ 0494 


Momson 


05/25/99 




99 DOJ 0496 


Momson 


05/25/99 




99 DOJ 0527 


Momson 


06/08/99 





4 



423 



NORTH CAROLINA REGISTER 



September 1, 1999 



14:5 



CONTESTED CASE DECISIONS 



> 



AGENCY 

PUBLIC INSTRl'CTION 

S.H-hy and through her guardian and cuslodian. H.H and HH \. 

Henderson County Board of Education 
SLF and S.FF- v.Charlotte-Mecklenburs Board of Education 



CASE 




DATE OF 


NUMBER 


AM 


DECISION 


98EDC 1124 


Mann 


06/1 1/99 


98EDC 1649 


Mann 


06/04/99 



PUBLISHED DECISION 
REGISTER CITATION 



STATE PERSONTVEL 



Department of Agriculture 

H C Troxler. Jr. v. Dept, of Agnculture and Consumer SerMces 

Community Coll, ges 

Thomas Michael Chaniherhn v Department of Community Colleges 

Correction 

E. Wayne lr\in \ Department of Correction 

Pershield DeLoatch v Department of Correction 

Deborah Smith \, Department of Correction 

Maydean L. Taylor v. Department of Correction 

Ann McMillian v. Momson Youth Institution. Department of Conection 

Edward Alan Roper v. DOC, Div. of Prisons. Western Youth Institute 

DeCarlos Stanley \. Department of Correction 

Harry E. Kenan v. Capt. B.F. Lewis, Polk Youth Institution 

Richmond Fulmore v. Department of Correctif A'ake Correctional 

lerry D. Crawford v. Department of Conect .. 

Charles Creegan v. Department of Correction 

Crime Control and Public Safety 

Thomas Michael Chamherlin \ DCCPS. Center for Missing Persons 

North Carolina School for the Deaf 

Enc ,\rden Hurley \ Nonh Carolina School for the Deaf 

^Employment Security Commission 

"Russell J. Suga \ Emplo\'menl Security Commission 

Health and Human Serx-ices 

Vera Crenshaw \. DHHS. .lulian F Keith Ale. & Drug Abuse Trtmt. Ctr 
hey G. Rhodes v. Pitt County Mental Health Center 
Dons Virginia Weanng v. Durham County Health Department 
Julia A. Cameron v. John Umslead Hospital. Health & Human Services 
Jency Ahrams v. Department of Health & Human Services 
Odell Hudson v. Health & Human Svcs.. Dorothea Dix Hospital 
Enca Joynes v. Durham County Department of Social Services 
Thomas Michael Chamberlin v. Off. of Juvenile Justice. Juvenile 
Sen ices Division. 14" District Court Division 



99 OSP 06.^9 


Chess 


99OSP0286 


Phipps 


94 0SP 1791 


Momson 


98 0SP 1026 


Gray 


98 0SP1I26 


Chess 


98 0SP1272 


Chess 


98 0SP127S 


Chess 


9S0SP 1644 


Grav 


99OSP0027 


Momson 


99OSP02,S7 


Phipps 


99OSP0416 


Mann 


99OSP0577 


Reillv 


99 OSP 076,'^ 


Reilly 


99OSP0.S96*' 


Gray 


99 OSP 0087 


Reilly 


96 OSP 1122 


Reilly 


98OSP04?6 


Grav 


98 OSP 0924 


Phipps 


98 OSP 14.12 


Reilly 


99OSP00,'i.1 


Momson 


99 OSP 0147 


Owens 


99 OSP 0609 


Grav 


99 OSP 0671 


Grav 


99 OSP 067.1'' 


Grav 



07/27/99 



06/2-';/99 



O.S/ IS/99 
08/11/99 
06/22/99 
0.VI4/99 
O.V 12/99 
08/11/99 
06/22/99 
06/07/99 
06/04/99 
06/02/99 
08/0.1/99 



08/16/99 



06/24/99 



0.'i/26/99 



08/05/99 
07/09/99 
06/18/99 
06/22/99 
08/11/99 
07/07/99 
07/1.1/99 
08/16/99 



14:01 NCR 60 



Johnston County 

till Romame Lee \ County of Johnston 

Justice 

Thomas Michael Chamherlin \. Justice. Justice Academy 

Labor 

Robert C .Adams v. Department of Labor 

Department of Public Instruction 

John Lee Herbm \ Smarkand Manor Training School 
Linda D, Chapman v Lenoir County Public Schools 

Transportation 

Charles W McAdams v. Depl. of Transportation, Div/Motor Vehicles 
Larry R. Lane v. Department of Transportation 
Ronald Roberson \. Dept. of Transportation. Right-of-Way Branch 
Shelvia Davis \ Department of Transportation 

'University ofSorth Carolina 

Wanda Troxler v. A & T State University and Dr. Ray J. Davis 
Vivian Smith Hammiel, Ling-ChihC. Hsu and Joel A. Williams v. East 
Carolina University 



99OSP04.S6 


Momson 


06/02/99 


99 OSP 0.108 


Phipps 


06/11/99 


99 OSP 0667 


Gray 


07/28/99 


99 OSP 027.1 


Gray 


08/04/99 


99 OSP 0691 


Reilly 


08/ 1 6/99 


99 OSP 00.14 


Mann 


06/23/99 


99 OSP 01 05 


Mann 


06/11/99 


99 OSP 0142 


Momson 


06/08/99 


99 OSP 01.56 


Owens 


06/2.1/99 


97 OSP 08 19 


Phipps 


08/02/99 


97 0SPI268*- 


Phipps 


07/06/99 



14:5 



NORTH CAROLINA REGISTER 



September 1, 1999 



424 



CONTESTED CASE DECISIONS 



Vivian Smith Hamniiel, Ling-Chih C. Hsu and Joe! A. Williams v. East 

Carolina University 
Vivian Smith Hammiel. Ling-Chih C Hsu and Joel A, Williams v. East 

Carolina University 
Jackie S- Flowers v. East Carolina University 

Anna Anita Huff v. Dr. Lonnie Sharpe/Dr. Reza Salami-Coll. /Engineering 
Thomas Michael Chamberlin v, UNC @ Chapel Hill. Depi. of University 

Housing. Division of Student Affairs 
Halycon Tudie Blake v University of North Carolina at Chapel Hill 



97 0SP1269*- Phipps 

97 OS P 1270*' Phipps 

98 0SP 1618 Reilly 
99OSP0599 Chess 
99OSP0674*' Gray 

99OSP0686 Gray 



(J7/06/99 

07/06/99 

06/24/99 
07/16/99 
08/16/99 

07/08/99 



I 



DEPARTMENT OK TRANSPORTATION 

Peter Kay,, Stem v. Department of Transportation 

UNIVERSITY OF NORTH CAROLINA 

Stephanie A. Payne v. UNC Hospitals 
Barbara A. Russell v. UNC Hospitals 
Rohm Perkins Stephens v. UNC Hospitals 
Rita Jo Kincaid v. UNC Hospitals 
Rita Jo Kincaid v. UNC Hospitals 



99 DOT 0668 


Owens 


07/29/99 


99 UNC 037.S 


Morrison 


06/21/99 


99 UNC 0540 


Gray 


08/11/99 


99 UNC 056.^ 


Owens 


07/21/99 


99 UNC 0746*' 


Reilly 


08/09/99 


99 UNC 0747*' 


Reilly 


08/09/99 



< 



♦ 



425 



NORTH CAROLINA REGISTER 



September I, 1999 



14:5 



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